Clinical and Psychopathological Differentiation of Endogenous Maniс-Paraphrenic States

Objective: clinical and psychopathologicaL differentiation of manic-paraphrenic states, the analysis of the relationship and mutual influence of manic affect and delusional disorders, the development of their typological classification, which is significant for improving diagnostics and prognosis.

Patient: the study included 78 female patients aged 18 to 55 years (mean age 33.6 years). In 56 cases the condition was qualified as manic-paraphrenic, in 22 as manic-delusional, without paraphrenic delusion and change in the self-consciousness. These conditions developed as part of the attacka of endogenous psychoses. All participants were in-patients of the FSBSI «Mental Health Research Centre» in 2016-2019.

Methods: the main investigation methods were clinical-psychopathological and follow-up study. Statistical processing was carried out using the program STATISTICA 10.0 for Windows OS.

Results: Based on the psychopathological analysis found heterogeneity of manic-paraphrenic states, which dealt both with the mechanisms of formation of delusion, and features of the manic actually affect the structure and describe the 2 types of manic-paraphrenic syndromes (MPs). In the first type of MPs noted the prevalence of mixed type formation of delusion on affective dominance in his picture of acute sensory delusion and, to a lesser extent, imaginative delusion. Manic affect was characterized by the dominance of ideational excitation. In the second type of MPs was observed exclusively non-affective formation of delusion dominated interpretative delusions and episodes of delusion of perception.

Mairritable mania. In patients with manic-delusional states dominated mostly affective mechanisms formation of delusion with a high proportion of imaginative delirium and much lower representation of delusions of perception in the presence of a typical manic triad.

Conclusions: the typology of manic-paraphrenic states, based on the characteristics actually manic affect and delusional disorders, their interrelationships, carries differentiated diagnostic and prognostic information important for optimization of therapeutic intervention.

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