Senile psychosis (senile psychosis) symptoms, treatment

With age, the human nervous system undergoes serious degenerative transformations: psychomotor reaction of the brain, cognitive functions, demyelination of the nervous fibers.

Such age-related changes significantly affect the quality of life not only of patients, but also of their environment.

Senile psychosis is a common pathology in psychiatric practice today.

The disease is difficult to diagnose in the early stages, which slows down the process of diagnosis and initiation of therapy.

Senile aggression, senile psychosis, involutional mental pathology or senile psychosis is a generalizing concept of one disease.

This condition is a manifestation of polyetiological mental diseases, which are manifested by impaired consciousness, endogenous mental disorders, for example, as:

• at schizophrenia,
• manic-depressive psychosisarising after 57-60 years.

A distinctive feature of the psychosis of old age from senile dementia is the absence of severe progressive dementia In the first case.

Aggression is a destructive behavioral attack of a person that contradicts the norms of a person's life in society, is destructive for the aggressor himself and his environment.

Aggression in the elderly at the initial stage of the process is difficult to distinguish from other degenerative diseases of the nervous system:

• Alzheimer's disease;
• Pick's disease;
• Huntington's disease;
• Parkinson's disease.

Etiology

As mentioned above, the main reason for the occurrence of a disease such as senile aggression is degenerative processes in neurons.

There is an opinion about the influence of infectious processes of the membranes and matter of the brain, traumatic brain injury in history and hereditary etiology on the occurrence of a pathological condition.

Background predisposing factors include sleep disturbance in the direction of its decrease, protein and vitamin deficiency. consumed food, age-related loss of hearing and / or vision, restriction in physical activity and walking in the fresh air.

Classification

Allocate acute and chronic forms of aggression in the elderly. Any somatic pathology is a provoking factor for the acute course of the disease:

• polyhypovitaminosis,
• chronic diseases of the bronchopulmonary system,
• heart diseases,
• endocrine disorders,
• neurological diseases with focal neurological symptoms.

The acute form is the most common, develops abruptly and lasts up to 4 weeks before the period of remission. The latter can last from several days to several years.

Senile psychosis in chronic form develops mainly in women.

The disease of a mild degree is not always possible to correctly diagnose due to non-specific clinical symptoms. Despite the duration of the disease for up to 20 years, the mental activity of the patients is preserved.

Also, clinical psychiatrists distinguish four more stages or stages of the disease:

• Simple;
• deployed;
• final;
• confabulatory.

Senile psychosis: symptoms and clinical picture

Acute and chronic forms of mental illness always develop gradually, but over time lead to serious mental health problems.

1. Acute senile psychosis. This form of a pathological condition may be preceded by a prodromal period, the main signs of which may be increased fatigue, decreased attention, insomnia or nightmares, impaired appetite, lack of interest in self-service. Symptoms of acute senile psychosis include agitation, increased motor activity, an unmotivated feeling of fear, fussiness, strengthening of tendon reflexes, delusional ideas, which consist in the patient's fear of injury or damage from strangers, visual, tactile and auditory hallucinations, pathological stinginess, asthenic-vegetative state, progressive muscle weakness, insomnia or nightmares, impaired consciousness in the form of a stupor, rarely stupor or delirium.
2. Chronic senile psychoses manifests itself in the form of syndromes such as hallucinogenic, paranoid and hallucinogenic-paranoid or mixed. This type of condition is characterized by prolonged severe depression (a feeling of inner emptiness, apathy, asthenia, lack of interest in the joys of life and in life in in general), paranoid delusions in relation to the patient himself, delusional ideas in the form of fixing others on themselves, visual or auditory illusions, paraphrenic syndrome, rare amnesia.

In senile psychosis, intelligence is always preserved, which distinguishes it from other psychiatric conditions.

Clinical symptoms progress depending on the duration of the course of the disease.

• Simple form, manifestations of which are characterized by accentuation (sharpening) of character traits. For example, dissatisfaction becomes aggression, economy becomes stinginess, joy becomes euphoric, tearfulness becomes hysterical, and so on.
• Expanded step. The manifestations of this form are amnesia, usually retrograde, inversion of the day-night regime (increased activity at night, sleepiness during the day), disorientation in a familiar place and time.
• Final phase it can be an independent form or arise as a result of a deployed one in a few days. The patient is prone to complete insanity - complete emotional depression and exhaustion of the patient as a result of atrophy of the cerebral cortex.
• Confabulatory phase is a variant of the continuation of the final form. The patient develops delirium, excessive love for others, pathological friendliness, a desire to talk a lot.

Differential diagnosis of the condition

Senile aggression refers to the diagnosis-exclusion and can be made in the absence of organic lesions of various organs and systems. The disease must be differentiated from conditions such as:

• affective insanity,
• Alzheimer's disease,
• Bonnet hallucinosis,
• oncological process of the brain,
• non-rheumatic carditis,
• thyrotoxicosis,
• hypovitaminosis,
• diseases of the gastrointestinal tract and other somatic and psychiatric diseases.

Diagnostics

Identification of a pathological condition is rather difficult due to masking of the disease and nonspecific primary manifestations. That is why, the doctor of the first link of treatment is not a psychiatrist, but a therapist, neurologist, cardiologist, endocrinologist.

The primary diagnostic criteria are based on complaints from relatives about the patient's behavior. Clinically, senile aggression can be suspected at only the stage of the expanded form.

To exclude organic pathology and differential diagnosis with other conditions, the patient is carried out:

• X-ray of the bones of the skull;
• CT and / or MRI of the brain;
• electroencephalogram;
• ECG;
• consultations with an oncologist, cardiologist, neurologist, endocrinologist.

What to do if pathology is detected (treatment)?

So what to do. Treatment can be divided into two categories: medication and psychotherapeutic, which cannot be used as monotherapy.

Patients and their relatives should be explained that there is no universal remedy for the treatment of senile psychosis, the disease cannot be cured.

The doctor, with the help of correcting the condition, reduces the symptoms of the disease and the rate of progression.

It is not necessary to hospitalize the patient immediately when making a diagnosis at the outpatient stage, since a change in the environment can aggravate the patient's condition. It is easier to prevent the progression of the acute form of the disease.

Relatives need to create comfortable conditions for the patient's stay in the apartment / house, help them normalize the daily routine with an emphasis on conducting free time in the fresh air, do not stop active communication with society, about opportunities to find new hobbies or activities for loved ones.

Medication methods of exposure are prescribed depending on the predominance of certain symptoms or syndromes. The main drugs of choice may be:

• Sonapax;
• Teralen;
• Propazin;
• Amitriptyline;
• Gidazepam;
• Haloperidol, etc.

The dosage and course of treatment are determined by the doctor individually. Additionally, it is necessary to correct somatic pathology as an etiological factor.

Psychotherapeutic treatment should cover the following goals and objectives:

• to convey to the patient the absurdity of the principles of his behavior and thinking, and as a result, the alienation of society from a person;
• constant recollection of pleasant moments in the patient's life, which eliminates or reduces the anxiety and anxiety of the patient;
• helping a relative to navigate freely in space, time and society;
• improving cognitive abilities (memory, speech, intelligence, gnosis and praxis) with the help of educational board games, including for children, solving puzzles, scanwords. puzzles;
• music therapy, art therapy, dolphin therapy, pet therapy, children's collectives, hobby in plant growing also have a beneficial effect on elderly people.

Forecast

If the patient was referred to a psychotherapist in the early stages of the pathological process, and adequate therapy was prescribed on time, the course of senile aggression can be easily controlled.

Patients with an acute form of the disease respond very quickly to correctly administered therapy.

In the chronic form of senile psychosis, it is almost impossible to achieve complete recovery, however to achieve a long and stable remission with a decrease in clinical manifestations with subsequent exacerbations is quite really.

The body's adaptive capabilities to the state are great, people get used to their disease.

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