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Table of contents of teaching
Organic mental disorders
Table of contents of teaching
Mental disorders due to the use of psychoactive substances
Table of contents of teaching
Psychogenic and affective mental disorders
Table of contents of teaching
Topical module POLYETIOLOGICAL MENTAL DISORDERS
Table of contents of teaching
DONETSK NATIONAL MEDICAL UNIVERSITY
Methodical directions for self-preparation
(for stomatologic students)
Donetsk – 2010
PSYCHIATRY. NARCOLOGY Methodical directions for self-preparation (for stomatologic students)
Abramov V.A., Ryapolova T.L., Vygovskaya O.M., Pyrkov S.G., Golodenko O.M., Denisov Y.M.
PSYCHIATRY. NARCOLOGY Methodical directions for self-preparation (for stomatologic students). – Donetsk: 2010. – 36 p.
It is intended for realization of the program-target approach to quality management of preparation of experts on medical psychology and psychiatry.
The purposes of each employment formulated, as professional skills are determined. Target tasks (training tasks) that allow the student to determine a degree of mastering of a theme are resulted.
Methodical directions are designed for controlled self-preparation of students of stomatologic faculty of higher educational institutions and are addition to corresponding manuals and textbooks.
Abramov V.A., Ryapolova T.L.,
Vygovskaya O.M., Pyrkov S.G.,
Golodenko O.M., Denisov Y.M.
This topic is the beginning of study of the general psychopathology and its main part – the semiotic of mental diseases.
Sensations and perception are the personal mental processes; they have subjective features, which are conditioned by personal properties of the organs of senses, knowledge, and experience. Subjectivity concerns to the level of depth of reflection and understanding and not to the reality of the objective existence of the perceptible. So, due to this the reality perceives in her natural condition, but with different level of the depth and understanding of its meaning.
Attention and memory is a mental process of imprinting, preservation and reproduction of the previous experience. Disturbances of memory and attention in mental and somatic diseases manifest themselves began inability to memorize, retain and reproduce the material mastered. Most frequently disturbances of memory occur in organic psychiatric disorders. It is possible to observe reduced capacity for memorizing against a background of a disturbance of attention in cases of development of overstrain states, as well ass at the period of convalescence following somatic diseases.
The disorders of emotions are leading in the clinic of mental and somatical diseases. During acute somatical disorder the reaction of personality to the fact of the disease appears. Its depth and steadfastness may differ, it may need psychotherapeutic or medicine correction. During chronic diseases more steadfast “totality of feelings” – “the inner picture of the disease” forms (R.A.Luria). Emotional may promote appearing of psychosomatic diseases. The disorders of emotions are often at psychosis, neurosis, and the disorders of personality. Because of the wide spectrum of the disorders of the emotions doctor of any specialty should be able to expose them and to carry out psychopharmacological and psychotherapeutic correction.
Identification of a mental disease like any other begins with the symptom (a sign which demonstrates a disorder of one or other function). But the symptom is a multimeaning sign and using the symptom alone it is impossible to make a diagnosis. A single symptom has a diagnostic sense only in the interaction with other symptoms or in the aggregate of syndrome (complex of symptoms). Syndrome is a number of symptoms, which are interacted by one pathogenesis. A clinical picture of the disease and its development consist of syndromes and their consecutive change.
^ to be able to expose and differentiate the breaches of sensations and perceptions; to be able to expose and to classify the disorders of the emotions; to be able to reveal psychopathologic syndromes for further diagnosis of mental disorders.
You can check the level of your knowledge with the help of the tasks:
Task 1. Patient S., 35 age, reading an interesting book didn’t notices his parents entering his room and as king him a question. One to which property of attention didn’t he react to the patients?
Task 2. A 68-year-old woman with cerebral atherosclerosis complains in a fatigue, irritability, frequent headaches, absent-mindedness, insomnia. From 60 ages has decreased of memory, forgot phone numbers, names of relatives. At the examination: exhaustion of attention, remember of 10 words: 3, 3, 4, 3, 4. Which processes of memory has disturbanced in this patient?
Task 3. During the research by the “Exemption of the superfluous” method the examinee choosed the thermometer from the group of things (thermometer, watch, glasses, balance). He explained that only sick persons need thermometer. Define the type of thinking:
Task 4. During the explanation of the metaphorical meaning of the proverb “An apple falls near the apple-tree”, the examinee told that “an apple always falls near the branch, on which it has been growed”. Define the type of thinking:
Task 5. A 36-year-old patient L. was referred by a therapeutist for consultation. The patient complained of a swollen head, numbing brain, knocking in his ears; his tongue getting swollen up. The patient was anxious, his mood was depressed, he was afraid that he had a brain tumor. The therapeutic examination did not reveal any pathology of the internal organs. Determine the patient’s feeling:
Task 6. A 40-year-old patient K. was delivered to the mental hospital by his relatives. A few days before his relatives had observed the patient sleeping badly and depressed his mood. Once at night his behavior was irrational. He began to listen to, checked if the door was closed, he was looking out of the window, and watched something with a great attention. He was sure that somebody was watching him and wanted to kill him. In admission department: the patient’s mood is depressed and suspicious. The patient oriented himself, in the time and space correctly. He reported some anamnestic facts, but he did it reluctantly. He said that he heard “some strange conversations”, behind the wall a few people discussing his actions and behavior. Some of them said that he was a “good-for-nothing man”, “a criminal”, that he did harm to his family that’s why he must be punished, even killed. And the others tried to protect and approved; recalled his merits and asked to “pardon” him. He did not see the people speaking but he heard the voices clearly and distinctly. He complained of the sense of fear, asked for help. What disorder of perception took a place?
Task 7. Patient S., aged 87, is a pensioner. For the last 5 years her relatives have noted her forgetting the relatives names. She cannot remember where she has put her things. She takes reckless actions and is helpless: when she leaves the house she is unable to come back because of forgetting her address. When examined by the psychiatrist she demonstrated an odd allopsychic orientation. She could not say how old she was. She could not say how many children she had and what their names were. The critical attitude to the disease is absent. Which memory disorder takes place?
A. Hypomnesia C. Retromnesia
B. Anteromnesia D. Fixation amnesia E. Cryptomnesia
Task 8. Patient N.is 42 years old. Mental disorder appeared after the major operation. The patient complains of weakness, inability to concentrate his attention, “to collect his thoughts”. He easily gets tired in mental and physical activities. The patient states that he cannot keep in memory a text read. In conversations he loses the thread of talking. Objective examining: physical weakness, skin is pale. Arterial pressure – 90/60. There are no place have any pathology of internal organs. Neurological condition is normal. Mental state: he answers the psychiatrist’s questions correct, but in a slow tempo. Predominantly he gave short answers (only a few words). More complicated questions make the contact worse. Answers of a refusal character appear. It was difficult for the patient to concentrate his attention till the end of conversation, he gets tired quickly. Which pathology of attention takes place?
Task 9. Patient G. was a 14-year-old boy. His early years passed uneventfully. He growing as a merry and cheerful child. He finished 7classes of a middle school, he was studying in a musical college. Before hospitalization he became fussy and to match cheerful, garrulous; he was asking for some money from his neighbours and was sending it for sweets. Psychical condition in stationary department: patient is easy for a productive contact, his mood is rised, he is garrulous. He jokes all time, he strive for activities, interferes everywhere, “makes order”. He starts to make a lot of business, makes plans of the reorganization of department, but he doesn’t finish anything from that. Patient is fussy, unconsistent, friendly, easy irritable, can be coarse, he doesn’t keep regime but calms quickly. What kind of emotion’s breach has a place?
Task 10. Patient K., 8 years old. He was easy bitterness in early childhood, pinched his mother, beat his parents by legs, he hadn’t any reaction to punishment. He was dehampered, in a kindergarden he beat another children and spited in their plates. He was trying to burn different stuffs, tried to find matches, once he had set shed on fire. In a school he beat another children, during classes he got up on a desk, stained another children by ink. He was tormenting cats and draging them on their tails, “he was training them for pain”. Qualificate these branches of behaviour of this patient.
Task 11. Patient A., 44 years old, the main engineer of industrial production. He turned to the therapeutist with complaints to branch of his sleep. He couldn’t fall asleep for a long time, he couldn’t get thoughts about his work and events of a past day out of his head. His fitting for a work was decreased; during evenings he can not to concentrate on his deals. He is irritable, he can’t tolerate bright light and voices. He complains of heartbitting, interruption and pricking in heart-region. At home he was irritable very often because of trifles; last time he is impatient with his work-group. The beginning of the disease coincided with conversion to another job. He found a lot of defects in production’s organization and plunged into the work. He was analyzing every small detail, he tried to inculcate in every department more progressive methods. He had a very dense schedule; he was working even during the dinner-break. After working day he took to home personal cases of his collaborators and learned them. New orders in production wasn’t liked by everyone. His collaborators were in bewilderment and they were discontented. Open conflicts appeared. Patient’s wife said him that he doesn’t give attention to family enough. Patient was thinking very often that these relations with a wife can have a bed end but he couldn’t change his relation to his family because he was carried by production’s interests. After appearing of these complaints it was hard for him to join in work. The therapeutist’s examining didn’t revealed any somatic pathology. What syndrome was described?
A. Depressive C. Hypochondriac
B. Psychoorganic D. Imposive E. Asthenic
Task 12. Patient Z., 40 years old. His father and father’s brother were treatment in psychical hospitals. The first attack of disease of this patient happened when he was 25 years old. From this time he was hospitalized in psychical department four times for 2 or 3 months, wrote out in a good condition, set to his job. This attack began 3 days ago. Patient became euphoric, exciting, to active. He began to repair his flat, arranged disorder and stop it. He bought weight and gave the promise that he will be the world champion in a hard athletic. He was trying to speak on a scene and when he was stopped he began a quarrel he was beating his friend. Psychical status: patient is moving restless. He can not stand on one place, he is walking along the department, beginning to do different business, beginning different activities but digresses at once. He is singing, dancing, challenging the doctor which cures him for a fight; he became irritable. Sleeping is not enough in spite of treatment by corresponding medicines. Easy for connecting. Qualificate this psychopathologic syndrome.
After learning of the chapters of the exercise-book and the text-book solve the tests. If your answers are wrong, read the chapters of the exercise-book and the text-book for the second time.
Tasks for self-control
Task 13. A 17-year-old patient was hospitalized in neurosurgical department in a comatose state following a brain trauma. When he regained his consciousness, he couldn’t recall what he did in the morning, which he saw on the way, where he fell down. Determine the type of disturbance of memory in these patients?
Task 14. The patient 80 ages doesn’t recognize her children and grandchildren, doesn’t remember their names and age, her address, where she worked and the position she occupied, if her husband is alive. From her daughter’s words, disturbances of memory in the patient appeared 5 years ago and developed in the following way: at first she forgot recent events, and then her memory began to lose more remote ones. What disturbance of memory does the patient have?
Task 15. The patient K. 36 age in during examination speech fast with prevailed of mechanical associations. The patient reveals of increased ability of reproduction of separate details since the last life. Recites of poems from the school program. What disturbance of memory does the patient have?
Task 16. Patient S., 26 years old, invalid of III group, suffers from mental disease since 14 years. Disease got malignant course. During last years the patient is in closed department of psychiatric clinic. Psychical condition: productive contact is difficult; it’s hard to draw his attention. Speaking is incoherent, often in a form of monologue. The patient is inactive, careless, spends much time in a bad. The patient is cynical. He masturbates in staff presence; he doesn’t find staying in the department hard. He doesn’t show interest in his mother’s dating. Which of the disorders of emotions was described?
Task 17. Patient G., 58 years old. She thinks that she’s been suffering from the disease during last two years. During the admission to the psychiatric clinic she tells about her disease readily and in details, strokes the doctor’s hand, asks about help with the tears in her eyes. She tells about her tearfulness “I can’t see a pitiful film without tears” “I always cry when I tell my grand-daughter about my youth”. During the conversation patient cries. In the department sometimes registers stormy highly emotional reaction on the less cause. Patient says “Earlier I was very patient, and now I burn as a match”. Which of the disorders of emotions was described?
Task 18. Patient O., 23 years old. Soldier of a 2nd group cause of psychical disease. Was treatment in a psychical hospital few times.
During five years she hearing voices which coming from the street. These voices are silent, they become more intensive during sleepless, agitation and in a silence. Women and children are speaking. They call her somebody else’s name, give advices how to do. These voices speaks to patient and between themselves, discusses her behaviour. Last time accept these voices which come from outside, voices which located inside her mine had appeared. But she is hearing them by her ears, she describes it as a real. She never talks with these voices and last few years she doesn’t follow their advices. She has no critic to her psychical condition. Sometimes during the explanation she says they it’s just a “fantasy which climbs in her mind” but following the appearing of voices she recepts them as a real. Qualificate this psychopathologic syndrome.
Task 19. Patient N., 19 years old. Was delivered in psychical hospital by her parents. Mother’s brother is ill on schizophrenia. She had fallen into the illness suddenly, after the quarrel with a boy. In psychical hospital she was hindered during a week, with a fixed countenance. She lied in a bed motionlessly and turning to wall. She didn’t speak to anyone and refused of eat, she wasn’t answering any questions. Twice she had became exciting, she was screaming fragments from phrases, made disorder, she wasn’t connecting to anyone. When the attack finished she told that she seems she was driving around the country, saw herself in a luxury conditions and among personages from stories. People was dancing around her in strange cloth, pleasant music was ringing. She thought that she merries with italian singer Celentano and takes part in wedding ceremony. Sometimes she was afraid, she thought that the war had started, there were tanks around her and a lot of plains in the sky. Sometimes she thought that special scenes were playing special for her and something was installing inside her. What psychopathologic syndrome was described?
Task 20. Patient B., 54 years old. Has quiet character, high capacity for work, she is careful. Menopause from 46th year. Joined to psychical hospital at first. She was falling ill gradually: lost appetite and sleep, her mood was depressed; there were appeared thoughts that she has a cancer and will die soon. She became disturbing.In department she speaks a little, complains of a general weakness. She is moaning, deep breathing. She thinks that she will die due to cancer, that her husband and her children will die. She is throwing, can’t seat on one place, striving to “say good buy to children”. She is tearing shirt on herself. Disturbing, all time asks: “What it got to be?” She is speaking about some misfortune which approach; she is depressed; there is a mask of suffering on her face. Tonight she was trying to tighten a towel on her neck. She eats only from hands of nurses, by they order.What psychopathologic syndrome was described?
Task 21. Patient N., 42 years old, doctor. He joined to psychical hospital at sixth. Every time he wrote out in a good condition, continues his work by his special. Last attack had a place 2 or 3 weeks before he entered. His mood is increased, he doesn’t sleep enough at night. He is interfering everywhere, giving advices. He is overrating his abilities.In a hospital he is easy for contact. Has a high temp of mentality, his speeches are bright, it is according by different gestures and countenance. He answers question with high desire but he digresses from one object to another very quickly. He is singing, reading his poetry, making rhymes. He hasn’t critic to his condition even on the contrary he notes the increasing of his energy, “excellent mood”, has an intention to conduct serious researching in sphere of onkological problems during a very short time.What psychopathologic syndrome was described?
Task 22. Patient K., 10 years old. He was growing and developed without any species. In a school he has a good results. He was falling ill 2 days ago, a headache had appeared, weakness, catharral appearances. Temperature is 38,0-39,5 degrees. A doctor which was invited established diagnose: adenovirus infection. At night he slept bed, he was throwing in his bad, cried out. On a morning he was disturbing, complained of fear without any motives. In a second part of a day he stopped to indicate his mother and brother, he thought that they are strange people; the cross reception of real subjects had a place; the stack of a steam heating which had a green colour he recepted as a snake. He was afraid he couldn’t to see “snake”; he can not to say where he is. Suddenly he began to crying and asking for help. There was find out that he recepted a lamp on a wall as his mother which was hang and had a small size. He sow beats from stories around himself. This condition had continued during day and night. When temperature had decreased his behaviour has changed, patient became quite, astenic and languid. He remembered some fragments from his condition. What psychopathologic syndrome was described?
Task 23. Patient 36 years old, driver. Was delivered into psychical hospital, his wife accompanied him. He drunks for a long time and a lot of match. During two last days branch of a sleep had place, he saw terrible dreams, before falling asleep terrible and ugly muzzles had appeared; patient was afraid. In psychical condition gave right information about himself, he couldn’t call the date directly; he was sure that he is located in the city Torez (city of his permanent address); he was confused, afraid and fussy; he is looking back all time, throwing off his cloth something and says: “What’s the muck! Where did you get so match spiders from?” It is hard for him to seat on one place; he told that he saw at home some strange animals, devils – they were teasing him and mocking him. When he tried to overtake them it was impossible; they were hiding quickly and appeared at another place. Suddenly patient jumped up on chair; there was a fear on his face. Elucidated that he tried to save himself from heaps of rats which are steal up to him from different sides. Described condition was continued all day and night. After deep sleep which was stimulated by special medicines appeared the improvement. Patient was interested where he is located; told about this experience; he had a poor remembers about his delivering to hospital. What psychopathologic syndrome was described?
Task 24. Patient Z., 43 years old. She characterized by tidiness, she was thoroughly and she demanded it from her collaborators. At the same time she was a little distrusted, disturbing, sensitive, selfish; she was easy to confuse of any cause. But she was self-controlled. She is living with her parents. When she was 41 years old during walking she was scratched by cat. She didn’t pay attention to it but later she heard that it may be cause of infection on rabies. Patient was disturbed, she hasn’t sleep all night, couldn’t soothe when she thought that she has infected. After vaccination, when the real danger has gone, the patient’s condition didn’t improved: she was afraid of the infection of rabies; she was disturbed when she saw cats and dogs. At the clinic patient washed her hands very often, evaded from contacts with people, required to change linen if she had the suspicion that somebody had touched it. She was afraid of pets. She knew that her trouble has no a real base but she couldn’t get free from it. Her mood is depressed, she think about infection all time. Sleeping doesn’t give expecting rest. What psychopathologic syndrome was described?
Task 25. Patient N., 36 years old. When he was working block was broken and beat him on his head. Patient had fallen from 6 meters and lost his consciousness. In that condition he was delivered to the surgical department of city hospital. The vomiting with blood had place. Month later he was transferred into the psychical hospital. Psychical status. Patient is able for a contact. In department he doesn’t busy. He spends a lot of time in his bad. He complains of a constant headache, general weakness, shows a huge branch of memory of present and past events; every day he makes his doctor acquaintance, promise to remember his name but after small time he forgets not only his name even his view. He doesn’t know names of nurses and another patients. He can’t remember executed medical procedures, time he was eating and what did he eat. He khows that it is the winter now and that he is located in a hospital. He indicates his location right. Called dates, month and year he forgets after 2 or 3 minutes. He confuses his room and his bad all time. He can’t give direct information about his life. He doesn’t remember his home address. He forgot the damage he had received and his location in a city hospital. He doesn’t know when he arrived to psychical hospital and how long he spent there. Sometimes he gave invented information about himself. His mood is increased. He doesn’t give an adequate estimation of his disease; he think that he is being there for health-checking. He isn’t friendly with other patients. Sometimes he become aggressive and irritable. These symptoms has no dynamic and retains during 2 years. What psychopathologic syndrome was described?
Task 26. Patient 37 years old. Following the information from the anamnesis he wasn’t backward in psychical and physical development from children of his age. He finished school and technical college successfully. He was working in a mine as a master. On his job he had a positive characteristic. When he was 30 years old received a hard damage of skull and brain, he was delivered in the neurosurgical department. During 2 weeks he was in coma. When he went out of this condition he couldn’t remember all events which happened before trauma. In this period he complained of a headache, general weakness, nausea; he was languid, sleepy, apathic. The oscillation of the arterial pressure had a place. Then there was an improvement on his condition but his memory was decreased. After being in stationary during 3 month he continued to receive the treatment at home. Then the 2nd group of soldier was legalized for him because he couldn’t started work again. Then in his behaviour was appeared atypical species. He lost the interest to outside world, he became uncarefull, he had no initiative, it was hard for him to do a usual work. Sometimes he was crying, was easy to irritate. All these symptoms progressed gradually. Neurulogical status: left eye split is more narrow than right; direct weakness of convergency of both sides; horizontal nistagm, Gurevich’s oculostatic phenomenon, a small difference between reflexes of tendineums. Rejecting in the Romberg’s position. Psychical status: patient is right oriented in his personality, has no direct orientation in space and he is absolutely disoriented in the time. Mentality is torpid, speech is slowly with a poor vocabulary. He cannot interpretate sayings, explain methaphores; he decides tasks on the creation of notions on a concrete level. In a process of the researching he tired quickly, in his conversation there is a lot of denials. What psychopathologic syndrome was described?
Task 27. Patient P., 34 years old. She is being ill on psycho during 3 years.
Psychical status: patient is languid, speaks reluctantly, she is trying to border herself by simple answers. She is looking at side. During the conversation she was trying to stand up and go out from room a few times. In department she doesn’t busy, spends all day in a bad. Contacts with another people only in case she need it. She has no critic to her condition. Her delivering in a hospital she associates with a suicide attempt. She explains that he made it under the influence of ”voices”. She told that she hears it all time during last few years; words of other people and their thinks has repeating in her head. Accept this “from radio by air” spreads voices on Russian and Ukrainian languages. Some people scolds her and say : ”Die!”. She always hears two voices, male and female. They speak loudly with intonations of menaces. They turn exactly to the patient, make orders, repeat the same a lot of time, demand it until patient will do it. She set off , cut her hand. “all because of them or why should I do it?” She hears these voices everyday, they orders are broadcasting on the radio, that’s why she asks to transfer her in department which doesn’t equipped by the radio. She observes that very she can see her body which is falling back and sometimes she can see her hands and face which are cutting by the knife. She thinks that all these events are the result of the activities of people group which were pursuing her with sexual intentions and after her refusal they are mocking.What psychopathologic syndrome was described?
Task 28. Patient A., 14 years old. Pubertate period was elapsing quickly, menstruation was directed when she was 12 years old. From this time branches of behaviour appeared; she became irritable, coarse and she hadn’t tolerant. She stopped to display respecting and carrying to her mother even during her disease. She received pleasure when she exterminated somebody. She beat her grandmother. In a pioneer’s camp she was trying to destroy tent, she “collected” executions, by cutting out of school daybook teacher’s reprimands and by noticed of a different ways of execution of another children. She asks to children of her age to “tell about their experience how exterminate somebody quickly”. In department of psychical hospital she is satisfied when it is possible for her to reduce somebody to crying. She teard strings on a guitare of a boy, at night she spread by toothpaste girl’s face, destroy player, teard an expensive girl’s leather jacket, shows the cruelty to boys which are pleased to her. Once of them she beat on his face by belt. She hasn’t any interests for productive activities. What psychopathologic syndrome was described?
Task 29. Patient K., 20 years old. There was no any species in the development in his childhood. After he finished the school he entered to the institute, he had a good results. One year ago he received a brain damage which was according with short-time consciousnessless, vomiting during a week. After the course of a treatment (at home) with using of a special medicine for dehidratation and sedative his condition was improved. After 2 weeks he went to lessons. Hi feel satisfactory but in comparison with the past time he feel some weakness. Then he noticed that it is difficult for him to learn a new material; he couldn’t concentrate his attention and during it’s extension a headache was appeared. He turned to a doctor. He complained of a general weakness, headache, sleeplessness, increased irritable, decreasing of his memory, increased sensitive to a sound signals. Neurological status: absent-mined microorganical neurological symptoms; oscillation of the arterial pressure; high level of sweating. Psychical status: patient shows right allopsychical and autopsychical prientation. Gallucinative and delirious productions have no place. Intellect is saved but during the decision of complete tasks patient feel some difficult, following his explaining it cause of impossibility to concentrate the attention. He is getting tired quickly. After the short-time rest he can decision more difficult tasks. There was revealed the decreasing of the memory. His mood is decreased (a little), irritable weakness is coming quickly, it is according be the vegetative and vestibular braches. What psychopathologic syndrome was described?
Task 30. Patient K., 58 years old. When she was 54 years old she began noticed “the eye influence” from her neighbours which had an object to receive her room. Few times she was on a stationary treatment. Psychical status during the examining: consciousness is clear, absolutely oriented. At the beginning of conversation she is extensive, answers the question after short pause, then she tells about conflicts with her neighbours with all details. She speaks silent, her face shows suffering. She tells that “something strange is happening” around her. She hears suspicious rustle from her neighbourse’s room. She told: “When I open the door the neighbourse’s is slaming ”. Patient is sure that some of them penetrates in her room when she is absent. She noticed that some stuff were disappeared but later it suddenly were appeared. Neighbours “dispatche her by gases and tobacco smoke”, she feel “strange supplement” in the air, feel breathlessness and cold at night. She is sure that her neighbours do it all to “bring her into the hospital” and then receive her room. Her mood is decreased. Formal abilities are normal. She has no contacts with other patient, has no critic to her condition. What psychopathologic syndrome was described?
Task 31. Patient S., 21 years old. The inheritance is burdened – his father’s sister is ill on schizophrenia. After he finished eight year of study he refused to continue his education, he consented to go for a work but he had no interest to his job. He became cruelty with his mother. Ha had a bed sleep. Then he stopped to go out of home because he seems that “people around him are looking at him badly”. He spent all day in his bad turning to a wall, he wasn’t speaking to anyone. Once when he was in a room he heard a man’s voice which was spoken to him that he is bed and he mustn’t live in this world. Then he began to hear these “voices” more often. He was trying to discussed with them, excused himself. Accept the charge to his address these voices said that his mother is a bed woman, he made him unhappy, he is torturing because of her and must kill himself and his mother. Patient “understood” that he catched under the hypnose from some group of people and there is only one exit – to die. Then he didn’t get up from his bad, didn’t answer questions; he was seating during a long time and watching to one point of space; heard for something; sometimes he whispered something. His mood was decreased. He heard “inside his head conversation of unpleasant content” all the time. Very often he couldn’t to understand whose voice it is. Gradually he understood that all his psychical activities doesn’t belong to him and he is under the power of hypnose. His thinks are well-known for people around him; when he begin thinking they already know it and put into his head somebody else’s thinks. They make him move by his hands, turn his head; due to the hypnose they create good or bed mood for him. And then patient came to the conclusion that people who manipulate him by the hypnose discovered that he is an extraordinary man and at the nearest time he have to discover secrets of the World, explain conceptions of all known physical laws, discover the cause of moving and all what is happening around the world. What psychopathologic syndrome was described?
Task 32. Patient 32 years old, librarian. Her mother was modest, feared, she had an increased feeling of the debt. Her father was cruelty, selfish, he had drunk a lot of match. During the childhood she was developing right. She was active, self-controlled, proud; was interested in literature. She completed the librarian’s courses when she was 19 years old. She was working conscientious, was receiving gratitudes. When she was 28 she became more mysterious, lack of conscientiousness was appeared, she lost her interest in reading; fired and went for a work into the hospital as a hospital attendant. She was working bed; on reprimands she answered by cruelty. One week before hospitalization after working day ending she didn’t go home but she was staying in a hospital and continued to work. She moved different stuff from place to place without any sense. She didn’t give any reaction to appeat to her, she was smiling unadequately that’s why she was delivered into psychical hospital. In department she lies without moving, her eyes are closed, she doesn’t change position of her body for a long time. Her raised arm is staying in the air in this position. She doesn’t give any reaction to any appeat. During attempts to feed her she shows a high resistance. He is wetting in a bed. What psychopathologic syndrome was described?
Task 33. Patient R., was born in 1928. His education consists of 7 years. During the Second World War he was wounded seriously on his leg. From 1961 he is sojourning in psychical hospital. He complains of a something people prevent him to sleep and a strange nematode inside him which is drinking his blood, screaming and spinning around. All eat he consides poisonous. He complains of an influence of the X-ray. From 1966 he complains that “devils” are climbing up to him. He tells about them even nowadays. By his words siluets of “devils” appear inside his organism and outside it. They are “advancing to him by echelons”. He tears their jaws and let angels which were absorbed by devils out. Devils keep knives in their hands. He confiscates their knives with a “small planet”. Devils are coming inside him throw his anus. Patient thinks that he is the Sun’s son. He can lead the Moon. Angels help him fight against devils. He has his own planet and his own siluet. He was weared in the Monomach’s cap; there is a war between them and the dark magic. They “closes his thinks” and make him drunk. Devils may have three heads. They wear on him sacks and by this way they tie him. What psychopathologic syndrome was described?
Task 34. Patient O., 19 years old, student. After endured virus of gripp she began to complain of a general weakness, difficult reception of a current material. Then people around her noticed that she during classes she is confused with an absent view and she doesn’t understanding the object of conversation. She cannot to understand simple questions, gives answers without senses. During the examining: Patient has a decreased nourishment, her temperature is 37,3 degrees. Psychical status: patient is hindered, she is difficukt for the productive contact. She answers the question only after repeating it for many times; a lot of them are misunderstood for her; she is looking by eyes which are opened wide; countenance is surprised. Processes of mentality are slowly, there are branches of processes of enrichment and syntesis. What psychopathologic syndrome was described?
Task 35. Patient D., 75 years old, pensioner. Present disease developed gradually. First of all the decreasing of the memory on a current events had a place. She has forgotten date and the day of the week, she didn’t remember what does she have to bye in a shop, she forgot to take a change during the shopping. She became irritable and weeped. During last years branch of the memory was progressing: she confuses flats, she couldn’t came home. Gradually she became cruelty. She was delivered in psychical hospital as a “unknown”. She can’t tell her name and address She is absolutely disoriented in a space, the time and the situation. She is confirming that she is 20 years old. She is trying to understand how to wear cloth and underwear right. She has no any questions and any interests. Her attention is very difficult for concentration. It is impossible to try research operations of the mentality because she doesn’t understand what is demanded from her. What psychopathologic syndrome was described?
Task 36. Patient N., 18 years old. Entered to the stationary expertise in consequence of negative school characteristic. There is well-known from the anamnesis that he was born after 7th pregnancy when his mother was 47 years old. During this pregnancy the toxic-attack had a place. He was born in a huge asfiction and well formed hydrocephalia. His father is a chronic alcohol-depending man. He was being on a treatment in psychical hospital a few times. In childhood he was ill on a scarlet fever and chicken-pox. He was backward on his psychical and physical development. He went to school when he was 8 years old, but he couldn’t master the program of publish school. He was directed to a special school for children with a mind’s weakness. He was finished four classes. From the pedagogical characteristic: he is obedient, carried out, very sensitive, crying a lot of match. During his studying he had a huge problem in a counting till “ten”, his reading is bed, he cannot retell the text. Multiplication table wasn’t mastered by him. The mentality is primitive and concrete. The level of mind’s operations is very low. He isn’t able to decide tasks for enrichment and abstraction. His memory is bed. Baggage of knowledge is poor and doesn’t correspond to his age. His vocabulary is poor. The structure of sentences is right. What psychopathologic syndrome was described?
|Donetsk 2012 ministry of health of ukraine donetsk National Medical University Gorky||Donetsk – 2009 donetsk national medical university|
|Donetsk – 2011 donetsk national medical university||Donetsk national medical university named after M. Gorkiy medical psychology|
|Donetsk National Medical University||M. I. Pyrogov Vinnitsa National Medical University Chair of Psychiatry and Addictology|
|M. I. Pyrogov Vinnitsa National Medical University Chair of Psychiatry and Addictology||Donetsk national medical university named after M. Gorkiy|
|Donetsk national medical university the name of M. Gor'kogo||Donetsk National Medical University of Maxim Gorky practice activity guidelines|