The course of psychopathy

Psychopathy, unlike psychosis, does not refer to progressive (progressive) diseases. However, this statics of psychopathy is conditional. It is true with respect to the preservation of the unity of the individual. Personality, depending on external conditions and the impact of other factors, can be adapted (compensated) or maladaptive (decompensated). Compensation for the psychopathic personality is accomplished in two ways. At the first under the influence of favorable social conditions, the pathological features of nature are smoothed out. The second way is aimed at developing secondary psychopathic traits in order to adapt to the environment (hypercompensation). Violation of social adaptation occurs, as a rule, under the influence of external factors (psycho-traumatic situations, somatic diseases, social conditions), and decompensatory factors should be significant for this person. For example, a conflict in the family will be a significant moment for an excitable psychopath and will not have any decompensatory effect on the schizoid personality. Decompensation is usually a marked increase in personality traits. So for example, depressive conditions often occur in hypotensive or cycloid individuals, hysterical reactions - in hysterical psychopaths, ideas of jealousy or litigation - in paranoiacs. There may be reactions that do not correspond to the nature of psychopathy, contrast type of personality. Thus, asthenic reactions appear in the excitable, in the hysterical, depressive reactions. This usually occurs in conditions of severe psychotraumatic situation (death of a loved one, desperate life situation, etc.). In such cases, shock reactions and reactive psychoses may occur (see).
Decompensation of psychopathy usually occurs during periods of hormonal adjustment in the body. The most significant in this regard are pubertal (adolescent) age and the period of involution (menopause in women). In addition, the sharpening of characterological features in women is observed during pregnancy, especially in the first half, after abortions, dysfunctional births, before menstruation.
Patoharakteralogicheskoe personality development, in contrast to psychopathy, is the result of improper education in the family, a prolonged impact of adverse social and psychotraumatic factors, and the psychogenic factor is the main one. For example, in conditions of constant suppression, humiliation and frequent punishments, such traits of character as shyness, indecision, shyness, self-doubt are formed. Sometimes, in response to the constant rudeness, callousness, beatings (in families of alcoholics), there also appears excitability, explosiveness with aggressiveness, expressing a psychologically protective reaction of protest. If a child grows in an environment of excessive adoration, admiration, praise, when all his desires and whims are fulfilled, then such traits of hysterical personality as selfishness, demonstrativeness, narcissism, emotional instability are formed in the absence of initiative and goals in life. And if, in addition, he is an ordinary person who does not really have talented talents, he has to assert himself and deserve the recognition of others in other ways (different from other appearances, unusual deeds, writing about himself different stories, etc.). Sometimes it is difficult to distinguish innate psychopathy from the pathocharacteristic development of the personality, especially as in the formation of congenital psychopathy, external factors play a far from last role.
In the compensation stage, psychopathic individuals do not need treatment. In the prevention of decompensation, the main emphasis is placed on measures of social impact: correct education in the family, school, measures for adequate employment and social adaptation, appropriate to the mental make-up of the person and the level of intelligence. When decompensation is used as methods of psychotherapeutic influence (explanatory psychotherapy, autogenic training, hypnosis, family psychotherapy), and drug treatment.
Psychotropic medications are prescribed individually, taking into account psychopathological reactions and personality traits. In individuals with predominantly emotional fluctuations, antidepressants are successfully used, with pronounced hysterical reactions - small doses of neuroleptics (aminazine, trifazine), in states of malice, aggressiveness - also antipsychotics (tizercin, haloperidol). With the expressed deviations of the behavior, "correctors of behavior" are successfully used - neuleptil, sonapaks. Severe asthenic reactions require the appointment of stimulants (sydnokarb) or natural drugs with mild stimulating action (ginseng, Chinese magnolia vine, zamanicha, levzeya, eleutherococcus, etc.). Selection of drugs, doses and methods of their introduction is carried out by a doctor-psychiatrist. For the period of decompensation, a temporary loss of ability to work with the registration of a sick-leaf is determined. Disability patients are transferred extremely rarely, with aggravating circumstances. The outlook is generally favorable.