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Involutionary paranoid


- psychosis, which first appears at the age of involution (reverse development) and is characterized by delusions of small scope or everyday relationships.
Symptoms and course:
The disease is characterized by the gradual development of persistent delusions against the background of clear consciousness and outwardly relatively ordered behavior. People from the inner circle (family members, neighbors, acquaintances) who are suspected of deliberately causing all sorts of trouble: sabotage, harassment, poisoning, and harm are involved in the delusional concept. The delusional concept usually does not extend beyond the limits of narrow everyday relations, which is why it is called “small scope” or “everyday relationship” nonsense. Patients are convinced that the neighbors spoil their belongings, secretly climb into the apartment, pick up keys and master keys, sprinkle salt, poisonous substances into the food, let gas and so on under the door. Suspicious persons who conspire with them go to the neighbors. Everything is done with the specific purpose of "surviving" the patient from the apartment, causing material damage or injury. At the same time, patients can foolishly interpret their bodily sensations. For example, cough, palpitations are regarded as a result of gas poisoning, and gastric disorders, diarrhea - as poisoning with poisons spiked into food. Patients are very active and stubborn in defending their delusional beliefs and fighting imaginary enemies. They arrange surveillance, put numerous locks, “seals” on the door, write complaints to various authorities. Depressed mood, unlike melancholy, does not happen.
Perhaps the development of delirium in terms of ideas of jealousy, often in men. They are jealous of their neighbors in the apartment, in the country, to colleagues. The most common facts are interpreted crazy. For example, the wife talked with a neighbor over the fence, then she set up a date, met an acquaintance on the street by chance
- pre-planned meeting. A delusional system is created with inadequate assessment of past events (retrospective assessment). Patients with delusions of jealousy are socially dangerous, because may try to deal with the imaginary lover or mistress, as well as with the object of jealousy (wife, husband). Outside the sphere of delirium, patients retain social ties, are guided in domestic issues, and in some cases continue to work.
Recognition:
A distinctive feature of this disease is the late onset (after 50 years). The disease usually develops in a person prone to suspicion, punctuality, rigidity (sticking), which later develop into conflict, hostility, vindictiveness. Even with a long course of the disease, there is no tendency to the complication of delusional disorders, as is the case with schizophrenia, and dementia does not occur, unlike senile psychosis. Difficulties in determining the disease are usually at its initial stages, when the delusional statements of patients are taken for ordinary household quarrels, conflicts. It is especially difficult to understand the situation in communal apartments, when the real facts are intertwined with the fictional.
Treatment:
Conducted in the hospital. Neuroleptics (triftazin, haloperidol) are used in combination with tranquilizers (seduxen, phenazepam). Treatment with hormonal drugs is ineffective and even contraindicated (the same applies to involutional melancholia). A change of residence, sometimes recommended by doctors, brings only temporary relief. Patients calm down for a while, but then delusional statements are resumed (either the old theme comes to life, or they find new “enemies”). The prognosis for timely initiated treatment is favorable.