Reactive crazy psychosis (paranoid)
- False judgments and inferences arising from patients in connection with a particular stressful situation. Ideas may at first be overvalued, psychologically understandable, arising on real soil and at first susceptible to some correction, but then they turn into delusional ones, with wrong behavior and the patient’s lack of criticism of their condition. Such delusional psychosis can occur in isolation, including language. The emergence of psychosis contributes to the tension of the environment (military conditions), lack of understanding of someone else's speech, customs, as well as their own state, weakened by insomnia, overwork, alcoholism, malnutrition.
Fear, suspicion, and then thoughts of persecution, possible murder, appear. At the same time, there may be frauds of perception (more often in those under investigation who are sitting in solitary confinement) - patients hear the voices of relatives, acquaintances, children crying. Deliberate attitudes and harassment can occur in hearing impaired people due to difficult speech perception and misinterpretation of the behavior of others. Recognition of reactive paranoids usually does not cause difficulties. Situational conditionality of psychosis, the direct connection of its content with the psycho-traumatic situation and the reversibility of the state when the external situation changes - 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 its delusional ideas on another, who is in emotionally close contact with him (for example, a mentally ill mother — a daughter). For the occurrence of such a condition requires certain conditions. First, the presence of close communication or cohabitation of two people with relative isolation from others (sometimes they isolate themselves, not communicating with other people). Secondly, induced delusions usually appear on certain grounds, i.e. in individuals with psychopathic features (increased suggestibility, sticking, rigidity, anxiety, tendency to overvalued formations), mental underdevelopment, low cultural level. Subjects of induced delusions are associated with everyday events and are expressed in ideas of persecution, poisoning, jealousy, and charity. The induced patient, as well as the inductor, can be agitated and perform socially dangerous acts. Induced psychosis usually occurs with a change in the situation 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 - the psychogenic situation. Affective-shock reactions, if not transferred to another state, usually do not require the help of a physician. Other psychosis requires hospitalization. Therapeutic tactics are determined by the severity of the condition, the nature of the traumatic situation, its intended outcome, as well as the characteristics of the psychopathological symptoms. In any case, a favorable resolution of the psychogenic situation, for example, withdrawal of the charge, evacuation from the disaster area, returning home from the conditions of language isolation, contributes to a quick recovery. Conversely, a hopeless situation creates conditions for a protracted course of psychosis. In states of excitement, neuroleptics (aminazin, triftazin) and tranquilizers (seduxen) are used in injections. Crazy ideas are also stopped by peyroleptik (haloperidol, stelazin, epotarazin). In case of reactive depression, antidepressants are used (amitriptyline, gerfonal, pyrazidol, etc.).
The most important element of treatment is psychotherapy, the task of which is to eliminate excessive fixation on the traumatic situation and develop protective psychological mechanisms during the period of adaptation to its consequences. Psychotherapeutic work with the patient is carried out only when he leaves the acute psychosis, when he can already adequately perceive his surroundings, including the doctor's arguments, and critically evaluate 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 unsolvable or protracted psycho-traumatic situations, however, here too a transformation of the state and relative adaptation to new conditions take place.