Psychosis in systemic lupus erythematosus

Systemic lupus erythematosus is considered an ailment with a peculiar clinical picture. It is possible to find in the literature quite a lot of contradictory explanations of the pathogenesis and etiology of this disease. Some scientists considered it to be one of the types of skin tuberculosis, some put forward a variant of syphilitic etiology. But most researchers are confident in the streptococcal nature of this disease. The source of systemic lupus erythematosus can be a chronic infection in the form of different foci. Becoming pathogenic, the human streptococcus sensitizes, causing at the same time various changes in it, including psychosis.

Development of psychosis in systemic lupus erythematosus

Nephropathy is present in 60-80% of patients with systemic lupus erythematosus. There may be nephrosis-nephritis, focal nephritis, glomerulonephritis. It is on this soil that hypertension, uremia, and edema appear. With systemic lupus erythematosus, neurological, mental disorders are often observed. Psychoses in this disease occur in 29% of cases in the form of epileptiform seizures, hallucinatory-paranoid syndrome. Psychosis with red lupus often occurs, and the range is quite wide;From asthenic, senestopaticheski-hypochondriacal disorders, up to affective, also affective-delusional, onyroid-catatonic states.

Mental disorders in the form of affective, as well as affective-delusional and onyroid-catatonic states occur in polysyndrome lupus. When a febrile syndrome appears delirium. In the preterminal stage, the patients develop stunning, which goes into soporium and to whom.

Oneiroid state of consciousness in systemic lupus erythematosus is a disorder of consciousness. It is characterized by a combination of images of the real world, as well as fantastic ideas. In the form of the physiological basis of the onyroid consciousness, the inhibited state of the cerebral cortex indicates. During this state, strong and weak stimuli cause a similar reaction, or weak stimuli lead to the strongest reaction, with respect to strong stimuli.

Catatonic excitation is a condition manifested by prolonged or paroxysmal psychomotor anxiety. There is motor anxiety with meaningless movements and stereotypes, it is also possible the appearance of impulsive actions, negativism, echopraxia, aggressiveness, verbigerization. Sometimes the patients experience the mutual transitions of the catatonic stupor into excitation or, conversely, from excitation into stupor.

Psychosis in systemic lupus can be manifested by an affective condition - it is a short-lived, but violently flowing emotional outburst, accompanied by an extremely strong experience( anger turning into anger, also fear, reaching horror).The emergence of emotion, its development to an affective state is a consequence of changes in nervous activity.

Treatment of psychosis in systemic lupus erythematosus

Patients with acute as well as protracted symptomatic psychoses in systemic lupus erythematosus are hospitalized in a psychiatric hospital or in the psychiatric ward of a somatic hospital. In the latter case, patients should be under the constant supervision of an infectious disease specialist, also a psychiatrist and therapist.

Patients with usual psychoses are treated, as a rule, in a general hospital, where it is necessary to provide round-the-clock surveillance, especially when excited and depressed( the fact is that depressive patients often make suicidal attempts).Therapeutic treatment of symptomatic psychoses should be aimed at eliminating the cause of their occurrence.

Acute psychosis( symptomatic) with confusion of consciousness, as well as hallucinosis are effectively treated with aminazine. With protracted psychoses, various drugs are prescribed, depending on the clinical picture. With concubulosis, hallucinatory-paranoid and manic states, aminazine and other neuroleptics with pronounced sedative effect are shown. Depressive states in systemic lupus erythematosus should be treated with antidepressants.