Reactive delusional psychosis (paranoid)
- false judgments and conclusions that arise in patients in connection with a certain traumatic situation. Initially, ideas can be overvalued, psychologically understandable, arising on real ground and at first amenable to some correction, but then they turn into delusional ones, with incorrect behavior and the patient’s lack of criticism for their condition. Such delusional psychoses can occur in isolation, including linguistic. The emergence of psychosis contributes to the tension of the environment (military conditions), a lack of understanding of other people's speech, customs, as well as their own condition, weakened by insomnia, overwork, alcoholization, malnutrition.
There is fear, suspicion, and then thoughts of persecution, a possible murder. At the same time, deceptions of perception may occur (more often they happen to those under investigation, sitting in solitary confinement) - patients hear the voices of relatives, acquaintances, crying children. Delirium of attitude and persecution can occur in the hearing impaired due to the difficulty in perceiving speech and misinterpreting the behavior of others. Recognition of reactive paranoids is usually straightforward. The situational conditionality of psychosis, the direct connection of its content with a traumatic situation and the reversibility of the state when the external environment changes are the main diagnostic criteria.
Reactive paranoids also include induced delirium resulting from the emotional and psychological influence of a person suffering from delusional psychosis. The latter, as it were, imposes his crazy ideas on another person who is in emotional contact with him (for example, a mentally ill mother — daughters). For the occurrence of such a condition, certain conditions are necessary. Firstly, the presence of close communication or cohabitation of two people with relative isolation from others (sometimes they isolate themselves without communicating with other people). Secondly, induced delusions usually appear on a certain basis, i.e. in individuals with psychopathic characteristics (increased suggestibility, stuckness, rigidity, anxiety, a tendency to overvalued formations), mental underdevelopment, and a low cultural level. The theme of induced delusional ideas is associated with ordinary events and is expressed in the ideas of persecution, poisoning, jealousy, and litigation. An induced patient, like an inductor, can be excited and take socially dangerous actions. Induced psychosis usually disappears with a change of scenery and isolation of the patient from the inducer.
Treatment:With all reactive psychoses, it is necessary first of all (where possible) to eliminate the cause of the disease - a psychogenic situation. Affective-shock reactions, if they do not pass into another state, usually do not require the help of a doctor. With other psychoses, hospitalization is required. Therapeutic tactics are determined by the severity of the condition, the nature of the traumatic situation, its expected outcome, as well as the characteristics of the psychopathological symptoms. In any case, a favorable resolution of the psychogenic situation, for example, removal of the charge, evacuation from the disaster area, returning to the homeland from the conditions of linguistic isolation, contributes to a quick recovery. And vice versa, a hopeless situation creates the conditions for a protracted course of psychosis. In conditions of excitation, antipsychotics (chlorpromazine, triftazine) and tranquilizers (seduxen) are used in injections. Delusions are also stopped with peyroleptics (haloperidol, stelazine, etaperazine). In reactive depression, antidepressants are used (amitriptyline, herfonal, pyrazidol, etc.).
The most important element of treatment is psychotherapy, the task of which is to eliminate excessive fixation in a traumatic situation and develop protective psychological mechanisms during adaptation to its consequences. Psychotherapeutic work with the patient is carried out only when he leaves acute psychosis, when he can already adequately perceive the environment, including the doctor’s arguments, and critically assess the situation and his condition. In most cases, the prognosis is favorable, patients return to work. The prognosis is less favorable in the conditions of insoluble or protracted traumatic situations, however, here the state is transformed and relative adaptation to new conditions.