Presenile (presenile, involutional) psychosis

Presenile (presenile, involutional) psychosis - a group of mental illness, manifesting at the age of 45-60 years, occurring in the form of a depression (involutional melancholia) or delusional paranoid psychosis IPT paraphrenic structure (involutional paranoid). Much less frequently observed malignant form, occurring with agitation, confusion, incoherent speech; In addition, there is a late catatonia and hallucinatory psychoses of late life.

The etiology is unknown. Contributing factors may be transferred earlier psychogenic trauma and somatic diseases.

Involutionary melancholy occurs with anxiety, agitation and delusions hypochondriacal content, self-abasement; conviction. Possible suicide attempts. With the deterioration of the depressive ideas emerge or the enormity hypochondriacally-nihilistic delusions. Status agitated depression may be replaced by a depressive stupor. The course is usually protracted involutional melancholia; After 2-3 years, the state of mental weakness is formed with a constant depression and anxiety monotonous.

Involutional paranoia inherent specificity, routine detention of psychopathological disorders (delirium "small magnitude"). By category is usually nonsense jealousy, prejudice, persecution. Most often nonsense aimed at immediate surroundings - neighbors, colleagues, relatives, which the patient blames the abuse, damage to property, theft. Often there is the complication of the delusional system due to the accession of poisoning ideas verbal illusions and hallucinations. Patients remain active; signs of dementia can not be detected for a long time.

The diagnosis of presenile psychosis justified only in cases of disease, first emerged in the period of involution. In this case, however, very difficult to late differentiation of schizophrenia and manic-depressive psychosis. Delimitation from other diseases that occur in the involutional age, facilitated by the absence of disorders of the brain characteristic of atherosclerosis and senile dementia.

For the treatment of involutional depression use antidepressants (amitriptyline, etc.), In combination with neuroleptics [chlorpromazine, thioridazine (sonapaks) eglonil, chlorprothixene]. When resistant to psychotropic drugs states shows electroconvulsive therapy. When involutional paranoid prescribed antipsychotics (triftazin, haloperidol, trisedil, leponeks).