Rampant and false propaganda
Feverish, convulsive activity (figurative meaning)
Nervous disease, manifested in fits of irritability, convulsive laughter, tears
A state in which screams, tears, and laughter are combined
What is behind the hype?
Nervous breakdown with tears and screams
Seizure with laughter and tears
And scream, and laughter, and tears
Another name for psychosis
Mental illness, expressed in bouts of laughter and joy
Psychological illness, 7 letters, crossword puzzle
A word of 7 letters, the first letter is "I", the second letter is "C", the third letter is "T", the fourth letter is "E", the fifth letter is "P", the sixth letter is "I", the seventh letter is "I", the word with the letter "I", the last "I". If you do not know a word from a crossword puzzle or a crossword puzzle, then our site will help you find the most difficult and unfamiliar words.
Other meanings of this word:
Random joke:
Once, in a math class, Hacker couldn't multiply 200 and the result exceeded 65535. His head rang: "Overflow!"
Scanwords, crosswords, sudoku, keywords online
Epileptic dementia is characterized by the fact that against the background of the described personality changes, the thoroughness of thinking increases, the speed of mental processes slows down sharply. Memory worsens. Patients with great difficulty learn anything new. Vocabulary is depleted. All interests are centered on the disease. Patients become egocentric. Criticism to all these changes, as a rule, is absent. Treatment. The main principles of epilepsy treatment are strict individualization, duration, continuity. The most effective drugs in each case have to be selected individually, the same applies to dosages. Their increase and decrease should be carried out gradually. Violation of this principle can lead to an exacerbation of the disease, up to the development of status epilepticus. Drugs are used that are effective in the treatment of various types of epileptic seizures (phenobarbital, difenin, benzonal, suxilep, finlepsin, etc.). If the clinical picture is polymorphic, combinations of antiepileptic drugs are used. Further
Catatonic excitation
Catatonic excitation differs from manic in chaotic, unmotivated, unfocused. It can be detected to a limited extent - with complete immobility of the body, the patient makes stereotypical movements with his hands, grimaces ridiculously, spontaneously shouts out some. read the sequel
catatonic stupor
Catatonic stupor is expressed in complete immobility, and the position in which the patient is located may be the most unusual, uncomfortable. Sometimes patients lie motionless in bed in the so-called "embryonic position" - on their side, with their arms and legs bent and pressed to the body, with their eyes closed. read the sequel
Syndromes of movement disorders
Stuporous states are characterized by partial or complete immobility. The most common psychogenic, depressive and catatonic stupor. With psychogenic stupor, lethargy, mutism, refusal to eat are observed. Patients show complete indifference to what is happening around. read the sequel
Delusional Syndromes
The paranoid syndrome is characterized by a systematized delusion of attitude, jealousy, invention. The judgments and conclusions of patients outwardly give the impression of being quite logical, but they proceed from incorrect premises and lead to incorrect conclusions. This nonsense is closely related to the life situation,. read the sequel
affective syndromes
Manic syndrome is characterized by a painfully elevated mood, motor and speech excitement. Patients overestimate their capabilities, often express ideas of greatness. They are active, active, but their activity is unproductive - what they start is not brought to the end. In thinking is also absent. read the sequel
What is the name of the nervous disease (7 letters)?
It is unfortunate that at least one letter in the required word is not indicated in the question, because there are several diseases of the nervous system that fit this number of letters. You will have to briefly describe these diseases, and which one is suitable for a crossword puzzle - you choose! I will describe the words of seven letters in alphabetical order for ease of reading.
- Asthenia. Another name for the disease is “asthenic syndrome”. This is a psychopathological disorder. It begins gradually and can occur in almost any disease. With asthenia, exhaustion of the nervous system is observed. At the same time, a person complains of fatigue, decreased efficiency, insomnia, difficult awakening in the morning, a feeling of weakness, lethargy, increased irritability, tearfulness, fluctuations in blood pressure. In many cases, the cause of asthenia is some other disease or prolonged stress. Therefore, in the treatment of asthenia, it is imperative to treat the underlying disease, if any; adhere to the regime of work and rest, eat right, do what you love, from which the mood rises.
- Ataxia. This word can be translated from Greek as "mess". Indeed, the main manifestation of the disease is a violation of coordination of movements, motor skills. For example, the patient has a shaky gait, he cannot touch the tip of his nose with his finger, there is inaccuracy in movements, instability in a standing position due to imbalance.
- Migraine. This disease (also of seven letters) is translated from Greek as “half of the head” (hemicrania) and is manifested by a headache, which is most often concentrated on one side, it pulsates and intensifies with physical exertion or nervous tension. From a severe headache, nausea and vomiting often occur, which do not bring relief to the patient. Migraine leads to visual impairment, numbness, tingling in the limbs, their weakness. But, as the harbingers of an incipient migraine, sometimes even speech is disturbed, noise, light, and air movement are very irritating. Most often, migraine occurs in people at the working age of twenty to thirty years. For many, migraine occurs as a hereditary disease, but more often the cause is stress, overwork, and changes in hormonal levels.
- I will also call such a painful condition - "lumbago". This term neurologists call a severe painful backache in the spine in the lumbar region. Lumbago can occur suddenly with awkward movement or heavy lifting. This is a severe shooting pain that can even disable a person for several days.
Thus, the possible answers to this question are: Asthenia, Ataxia, Migraine, Lumbago.
P.S. Hysteria is sometimes mistakenly referred to as a nervous disease. But this is fundamentally wrong, since hysteria is a mental disorder.
Sign of illness
Answer to the 7 letter crossword puzzle: SYMPTOM
SYMPTOM - word meanings:
- The "call" of the disease
- "First call" of the disease
- Sore throat as a harbinger of a sore throat
- External sign of illness
- Beacon of Affliction
- medical sign
- unhealthy sign
- Unhealthy sign of illness
- Basis for diagnosis
- Sign of any disease
- The manifestation of the disease
- The manifestation of the disease
- Impact on health
- What portends the disease?
- Stroke to the picture of the disease
- fever in relation to the flu
Mental illness
Answer for the clue "Mental illness", 7 letters:
Alternative questions in crossword puzzles for the word hysteria
Nervous breakdown with tears and screams
And scream, and laughter, and tears
A state in which screams, tears, and laughter are combined
Another name for psychosis
What is behind the hype?
Rampant and false propaganda
Word definitions for hysteria in dictionaries
And, well. Mental illness, expressed in convulsive seizures, in tears, laughter, screams. An attack of hysteria. trans. Rampant and false propaganda, seeking to intimidate, forcing fear. Chauvinistic and. propaganda and. Military and. adj. hysterical.
Hysteria (from - "womb"); Uterine rabies is an outdated medical diagnosis, currently partly corresponding to a number of mental disorders of mild to moderate severity. Used to describe specific health and behavioral disorders.
neurosis, manifested by polymorphic functional mental, somatic and neurological disorders and characterized by great suggestibility and autosuggestibility of patients, the desire to attract the attention of others by any means.
Examples of the use of the word hysteria in the literature.
Muse was not sure that reading the letter would not lead to an aggravation hysteria and even the development of reactive psychosis.
And in the West there is just an orgy, hysteria anti-communism and anti-Sovietism.
Giving up resistance to the French in the Ruhr area and taking on the burden of paying reparations caused a wave of anger and hysteria among German nationalists.
Some other valve was needed to unwind hysteria, to release political steam.
Then she was sent to the front to edit a newspaper - there, during the retreat from Wrangel, in editorial cars, she went berserk, fell in love, became mad with love, she became a husband, who then fled to the Whites - and six months after that she, breaking with the Communist Party , with the revolution, was already on an errand in the Byurlyuk convent, in a black dress, like a jackdaw, - at prayer and in sexual hysteria.
Source: Maxim Moshkov Library
Mental illness 7 letters
Depression - salvation from complete collapse in the mental or physiological world of a person, Symptoms of the disease 7 letters. That is, he was provided with a job, Symptoms of the disease 7 letters, and therefore a good income, for a whole year. Let the most bitter feelings go away with these tears, Symptoms of the disease 7 letters. Hold your child at the most comfortable distance from your eyes. And if you want love, fill your soul and aura with it first. Where do I tend to take wrong steps on the physical level instead of trying new paths of spiritual development?
In addition, the combination of a miniskirt and fashionable daytime underwear that does not cover the crotch and buttocks creates an additional risk of heterogeneous infections entering the woman’s body through the “lower way” - at least in the conditions of summer city life with their street dust and dirt, which are far from sterile. public transport and other public places: it is enough to sit down unsuccessfully once, especially with the immune system - underdeveloped or weakened by spring vitamin deficiency - and trouble will arise. On the physical plane, intense breathing leads to a supersaturation of the body with oxygen and there is a slight poisoning by the products of its processing in the lungs. Contrary to common sense, everything that is near us seems large to us, Symptoms of the disease have 7 letters, and distant objects are small.
With scurvy, squeeze the juice into water, drink and rinse your mouth, you can eat lemon slices sprinkled with sugar (as well as other citrus fruits).
Practical Psychologist Dictionary
mental illness
(mental illness) - diseases characterized mainly by mental disorders. There are three main types:
1) psychoses of various etiologies - including schizophrenia, affective psychoses, paranoid states, etc.;
2) neuroses, personality disorders and other non-psychotic disorders - including psychopathy, special neurotic symptoms, drug addiction, etc.;
3) mental retardation - including mental retardation, etc.
Medical Directory of Diseases
Grace and beauty cannot be separated from health.
The medical directory of diseases that you see in front of you is an electronic encyclopedia containing the most complete up-to-date information on various human diseases.
The medical directory of diseases includes a detailed description of more than 1500 nosological units. It reflects both the most "popular", common diseases, and those systematized information about which is not presented in almost any online publication.
The structure of the medical reference book is built in such a way that you can find the disease of interest in the alphabetical rubricator, the corresponding section, or through the search bar. The description of each disease contains a brief definition, classification, information about the causes and mechanisms of development, symptoms, methods of diagnosis and treatment, prevention and prognosis. Such a clear unification of the articles, according to the authors of the online publication, will allow the reader of the medical reference book of diseases to obtain the most comprehensive information, on the one hand, and not “get lost in the wilds of medical labyrinths,” on the other.
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On the pages of the medical directory of diseases, you can get comprehensive information about women's, nervous, children's, skin, venereal, infectious, urological, systemic, endocrine, cardiovascular, eye, dental, pulmonary, gastrointestinal, ENT diseases. Each section of the medical directory of diseases corresponds to a specific clinical direction (for example, Women's diseases - Gynecology, Children's diseases - Pediatrics, Dental diseases - Dentistry, Aesthetic problems - Plastic surgery, Cosmetic problems - Cosmetology, etc.), which allows the user to navigate from the description diseases to information about diagnostic and therapeutic procedures.
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The universality of the medical directory of diseases lies in the fact that it will be useful to a wide range of Internet users who are faced with a particular health problem. The Medical Directory of Diseases is a doctor who is always at your fingertips! At the same time, we draw your attention to the fact that the information presented here is for informational purposes only, does not replace the face-to-face consultation of a specialist doctor and cannot be used for self-diagnosis and self-treatment.
"Praemonitus praemunitus" - "Forewarned is forearmed," said the ancients. Today, this winged Latin saying is as relevant as possible: everyone needs to take care of themselves and their health. Health is the only permanent fashion and the greatest luxury, which is incommensurable with any earthly goods. To be healthy means to be successful, to know the happiness of motherhood and fatherhood, to live a long and active life.
Health and beauty are inseparable; moreover, beauty is a reflection of the healthy state of the body. Indeed, in order to have perfect skin, a slim figure, luxurious hair, first of all, you need to take care of your physical and mental health.
We hope that the medical directory of diseases will become for you a reliable and understandable guide to the vast world of medicine.
Mental illness four letters
This section includes a wide variety of disorders that range in severity (from uncomplicated drunkenness and harmful use to severe psychotic disorders and dementia), but all of which can be explained by the use of one or more psychoactive substances, which may or may not be prescribed by a physician. .
This substance is indicated by the 2nd and 3rd characters (i.e. the first two digits after the letter F), and the 4th, 5th and 6th characters indicate the clinical condition. To save space, all psychoactive substances are listed first, followed by the 4th and subsequent characters; they should be used as needed for each analyte, however, it should be borne in mind that not all 4th and subsequent characters are applicable to all substances.
Some classes of psychoactive substances include both drugs and drugs that are not officially classified as drugs. In cases of dependence on sedatives or hypnotics (F13), stimulants (F15), hallucinogens (F16), volatile solvents (F18), use of several psychoactive substances (F19), the diagnosis of drug addiction is made if it is possible to determine dependence on psychoactive substances included in the official "List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation (Lists I, II, III)" (Decree of the Government of the Russian Federation of 30.06.1998 N 681). In these cases, after the main 4th, 5th or 6th character, the Russian letter "H" is placed. If the identified psychoactive substance is not included in the above "List", then the Russian letter "T" is put.
Dependence formed as a result of the abuse of a psychoactive substance classified as a narcotic drug is assessed
Like an addiction. Addictions include dependence on opioids
(F11), cannabinoids (F12), cocaine (F14). In this case, the letter "H" in
The end of the code is not affixed.
For alcohol dependence and alcoholism (F10), as well as tobacco dependence and nicotinism (F17), the letter "T" is not affixed.
Identification of used psychoactive substances is carried out on the basis of the statement of the patient himself, an objective analysis of urine, blood, etc. or other data (presence of drugs in the patient, clinical signs and symptoms, reports from informed third sources). It is always desirable to obtain similar data from more than one source.
Objective (laboratory) analyzes provide the most clear evidence of current or recent substance use, although this method is limited in relation to past or present levels of use.
Many patients use more than one type of psychoactive substance, but the diagnosis of the disorder must be made in relation to the individual psychoactive substance or type of substance that led to the existing disorder. When in doubt, the disorder is coded for the substance or type most commonly abused, especially in cases of chronic or daily use.
Only in cases where the system of drug use is chaotic and uncertain, or if the consequences of using different psychoactive substances are inseparably mixed, should the code
F19.- (mental and behavioral disorders caused by the simultaneous use of several drugs and the use of other psychoactive substances).
Abuse of non-psychoactive substances, e.g. laxatives, aspirin and others, should be coded F55.- (abuse
Non-addictive substances) with a 4th character indicating the type of substance.
Cases in which psychiatric disorders (particularly delirium in the elderly) are caused by psychoactive substances, but without signs of the disorders described in this section (eg, harmful use or dependence syndrome), should be coded in F00-F09. If delirium occurs in the background of one of the listed disorders, it should be coded in F1x.4xx.
The degree of association with alcohol can be determined by an additional code from ICD-10 Class XX: Y90 (proof of the presence of alcohol by blood test) or Y91 (proof of the presence of alcohol, determined by the level of intoxication).
Abuse of non-addictive substances (F55.-).
/F1х.0/ Acute intoxication
A transient state following the use of a psychoactive substance, consisting in disorders of consciousness, cognitive functions, perception, emotions, behavior or other psychophysiological functions and reactions, statics, coordination of movements, vegetative and other functions.
Diagnosis should be the main one only in cases where intoxication is not accompanied by more persistent disorders associated with the use of alcohol or other psychoactive substances. In the latter case, preference should be given to the diagnosis of harmful use (F1x.1x), dependence syndrome (F1x.2xx) or psychotic disorders (F1x.5xx).
Acute intoxication is in direct proportion to dose levels (see ICD-10 Class XX). Exceptions may be patients with
Kimi or organic diseases (for example, renal or hepatic insufficiency), when small doses of a substance can have a disproportionately acute intoxication effect. Disinhibition due to social circumstances (eg behavioral disinhibition at holidays, carnivals, etc.) must also be taken into account. Acute intoxication is a transient phenomenon. Its intensity decreases with time, and in the absence of further use of the substance, its action ceases. Recovery, therefore, is complete unless there is tissue damage or other complication.
Symptoms of intoxication do not always reflect the primary effect of the substance, for example, CNS depressants can cause symptoms of revitalization or hyperactivity, and stimulants can cause withdrawal and introverted behavior. The effects of substances such as cannabis and hallucinogens are almost unpredictable. Moreover, many psychoactive substances also produce different effects at different dose levels. For example, alcohol at low doses has a stimulant effect, with increasing doses it causes agitation and hyperactivity, and at very large doses it has a purely sedative effect.
The presence of head injuries and hypoglycemia, coma of other origins, as well as the possibility of intoxication as a result of the use of several substances should be borne in mind.
G1. Evidence of recent use of a psychoactive substance (or substances) in high enough doses to cause intoxication.
G2. The symptoms and signs of intoxication must be consistent with the known effects of the particular substance(s) as defined below, and must be of sufficient severity to result in clinically significant impairments in levels of consciousness, cognition, perception, affect or behavior.
G3. The symptoms or signs present cannot be explained by a non-substance related illness or other mental or behavioral disorder.
Acute intoxication often occurs in individuals who additionally have problems with alcohol or drug use. If there are such problems. for example, harmful use (use with harmful consequences) (F1x.1x), dependence syndromes (F1x.2xx) or psychotic disorder (F1x.5xx), these should also be noted.
Acute intoxication (intoxication) with alcoholism;
Acute intoxication (intoxication) with drug addiction;
Acute intoxication (intoxication) with substance abuse;
Acute alcohol intoxication;
Disorders in the form of trance with intoxication caused by psychoactive substances;
Disorder in the form of a state or trance with intoxication caused by psychoactive substances;
Acute intoxication (intoxication) when taking hallucinogens;
Acute intoxication (intoxication) NOS.
F1x.00x Acute intoxication, uncomplicated
Symptoms of varying severity, dose dependent.
F1x.01x Acute intoxication
With injury or other bodily injury
F1x.02x Acute intoxication with other medical complications
Acute intoxication with psychoactive substances, complicated by vomiting with blood;
Acute intoxication with psychoactive substances, complicated by aspiration of vomit.
F1x.03x Acute intoxication with delirium
F1x.04x Acute intoxication with impaired perception
Acute intoxication with psychoactive substances with delirium (F1x.03x).
F1x.05x Acute intoxication with coma
F1x.06x Acute intoxication with convulsions
F1x.07x Pathological intoxication
Applicable only in case of drinking alcohol (F10.07).
F1x.08x Acute intoxication with other complications
F1x.09x Acute intoxication with unspecified complications
Acute intoxication with psychoactive substances with complications of NOS.
/F1х.0хх/ Private forms of acute intoxication,
Caused by substance use
/F10.0х/ Acute intoxication,
Caused by alcohol
The general criteria for acute intoxication (F1x.0) must be met.
You can check the level of alcohol in the blood using the ICD-10 codes Y90.0 - Y90.8.
F10.0x1 Mild intoxication (acute alcohol intoxication)
It is expressed mainly by changes in well-being and behavioral disorders, among which may be: euphoria; disinhibition; propensity to argue; aggressiveness; mood lability; attention disorders; impaired judgment; violation of personal functioning; nystagmus; hyperemia of the face; injection of conjunctiva and sclera.
F10.0х2 Moderate intoxication (acute alcohol intoxication)
In addition to the symptoms indicated with a mild degree of intoxication (F10.0x1), neurological disorders are also observed, among which may be: unsteady gait; violations of statics and coordination of movements; blurred speech; nystagmus; hyperemia of the face; injection of conjunctiva and sclera.
F10.0x3 Severe intoxication (acute alcohol intoxication)
It is expressed by oppression of consciousness and vegetative functions, in particular: deep stupefaction, doubtfulness; stupor or coma; pallor and cyanosis of the skin and mucous membranes; arterial hypotension; hypothermia.
F10.07 Pathological intoxication (alcoholic)
This is a rare short-term acute psychotic disorder that develops in connection with the intake of alcohol even at low doses and proceeds, in the absence of clinical signs of ordinary alcohol intoxication, with impaired consciousness, agitation and aggression, and, as a rule, subsequent amnesia.
F11.0x Acute intoxication due to opioid use
There are signs of a change in mental state from among the following: apathy and sedation; disinhibition; psychomotor retardation; attention disorders; impaired judgment; disruption of social functioning.
drowsiness; slurred speech; constriction of the pupils (with the exception of conditions of anoxia from severe overdose, when the pupils dilate); oppression of consciousness (for example, stupor, coma).
In severe acute opioid intoxication, respiratory depression (and hypoxia), hypotension, and hypothermia may occur.
F12.0x Acute intoxication due to the use of cannabinoids
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: euphoria and disinhibition; anxiety or agitation; suspicion (paranoid mood); feeling of time slowing down and/or experiencing a fast flow of thoughts; impaired judgment; attention disorders; change in the rate of reactions; auditory, visual or tactile illusions; hallucinations with preservation of orientation; depersonalization; derealization; disruption of social functioning.
Signs may be present, from among the following: increased appetite; dry mouth; injection of the sclera; tachycardia.
F13.0xx Acute intoxication,
Caused by the use of sedatives or sleeping pills
When using this code, the following diagnostic principles apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: euphoria and disinhibition; apathy and sedation; rudeness or aggressiveness; mood lability; attention disorders; anterograde amnesia; disruption of social functioning.
Some of the following may be present: unsteady gait; violations of statics and coordination of movements; slurred speech;
nystagmus; depression of consciousness (for example, stupor, coma); erythematous
Or bullous skin rashes.
In severe cases, acute intoxication with sedatives or hypnotics may be accompanied by hypotension, hypothermia, and inhibition of the swallowing reflex.
F14.0x Acute intoxication due to cocaine use
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: euphoria and a feeling of increased energy (energy); increased levels of wakefulness ("hyper-wakefulness"); reassessment of one's own personality; rudeness or aggressiveness; propensity to argue; mood lability; stereotypical actions; auditory, visual or tactile illusions; hallucinations, usually with the preservation of orientation; paranoid mood; psychomotor agitation (sometimes lethargy); violations of social functioning from excessive sociability to social isolation.
Some of the following may be present: tachycardia (sometimes bradycardia); cardiac arrhythmia; arterial hypertension (sometimes hypotension); sweating and chills; nausea or vomiting; pupil dilation; muscle weakness; chest pain; convulsions.
F15.0xx Acute intoxication,
Caused by other stimulants (including caffeine)
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: euphoria and a feeling of a surge of energy; increased levels of wakefulness ("hyper-wakefulness"); reassessment of one's own personality; rudeness or aggressiveness; propensity to argue; psychomotor agitation (sometimes lethargy); mood lability; stereotypical actions; auditory, visual or tactile illusions; hallucinations, usually with the preservation of orientation; paranoid mood; violations of social functioning from excessive sociability to social isolation.
Some of the following may be present: tachycardia (sometimes bradycardia); cardiac arrhythmia; arterial hypertension (sometimes hypotension); sweating and chills; nausea or vomiting; possible weight loss; pupil dilation; muscle weakness; chest pain; convulsions.
F16.0xx Acute intoxication due to the use of hallucinogens
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: anxiety and timidity; auditory, visual or tactile
New illusions and / or hallucinations that occur in the waking state; depersonalization; derealization; paranoid mood; relationship ideas; mood lability; impulsive actions; hyperactivity; attention disorders; disruption of social functioning.
Signs from among the following may be present: tachycardia; heartbeat; sweating and chills; tremor; pupil dilation; violations of coordination; decrease in visual acuity.
F17.0x Acute intoxication due to tobacco use
(acute nicotine intoxication)
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: mood lability; sleep disorders.
Signs from among the following may be present: nausea or vomiting; dizziness; sweating; tachycardia; cardiac arrhythmia.
F18.0xx Acute intoxication due to ingestion of volatile solvents
When using this code, the following diagnostic rules apply:
General criteria for acute intoxication (F1x.0) are identified.
There are signs of a change in mental state from among the following: apathy and deep, close to lethargic, sleep; rudeness or aggressiveness; mood lability; impaired judgment; impaired attention and memory; psychomotor retardation; disruption of social functioning.
Some of the following may be present: unsteady gait; violations of statics and coordination of movements; slurred speech; nystagmus; depression of consciousness (for example, stupor, coma); muscle weakness; blurred vision or diplopia.
Acute intoxication from inhalation of substances other than solvents should also be coded here.
In severe cases, acute intoxication with volatile solvents may be accompanied by hypotension, hypothermia, and inhibition of the swallowing reflex.
F19.0xx Acute intoxication,
Caused by the simultaneous use of several drugs
Means and use of other psychoactive substances
This category should be used when there is evidence of intoxication due to recent use of other psychoactive substances (eg, phencyclidine) or multiple psychoactive substances, where it is not clear which substance is the main one.
/F1х.1/ Harmful (with harmful consequences)
A pattern of substance use causing harm to health. The harm can be physical (eg, in the case of hepatitis as a result of self-administration of injecting drugs) or mental (eg, in the case of secondary depressive disorders after heavy alcohol use).
This category diagnoses repeated substance use with clear medical consequences for the substance abuser, without evidence of dependence syndrome as defined in F1x.2xxx.
When making this diagnosis, it is necessary to have direct damage caused to the psyche or physical condition of the consumer. Substance use is often criticized by others and is associated with various negative social consequences. The fact that the use of a certain substance causes disapproval from another person or society as a whole, or may lead to socially negative consequences, such as arrest or dissolution of marriage, is not proof of use with harmful consequences.
A. There must be clear evidence that the use of the substance has caused or significantly contributed to physical or psychological harmful changes, including impaired judgment or dysfunctional behavior.
B. The nature of the harmful changes must be identifiable and described.
C. The pattern of use persisted or recurred periodically in the previous 12 months.
This category does not include acute intoxication (see F1x.0xx), dependence syndrome (F1x.2xxx), psychotic disorders (F1x.5xx) or other specific forms of alcohol or drug use disorder.
Substance abuse.
/F1х.2/ Dependency syndrome
A combination of somatic, behavioral and cognitive phenomena in which the use of a substance or class of substances begins to take first place in the individual's value system. The main characteristic of the addiction syndrome is the need (often intense, sometimes overwhelming) to take a psychoactive substance (which may or may not be prescribed by a doctor), alcohol, or tobacco. There is evidence that a return to the use of psychoactive drugs after a period of abstinence leads to a more rapid onset of signs of this syndrome than in individuals who did not previously have a dependence syndrome.
An addiction diagnosis can be made if 3 or more of the following occur over a period of time during the year:
A) An intense desire or feeling of an overwhelming craving to take a substance.
B) Decreased ability to control substance use: its onset, end or dose, as evidenced by the use of the substance in large quantities and for a period of time longer than intended, unsuccessful attempts, or a constant desire to reduce or control the use of the substance.
C) A state of withdrawal or withdrawal syndrome (see F1x.3xx and F1x.4xx) that occurs when the use of a substance is reduced or discontinued, as evidenced by a complex of disorders characteristic of that substance or by the use of the same (or similar substance) to relieve or prevention of withdrawal symptoms.
D) Increased tolerance to the effects of a substance, consisting in the need to increase the dose to achieve intoxication or the desired effects, or in the fact that chronic use of the same dose of the substance leads to a clearly reduced effect.
E) Preoccupation with substance use, which manifests itself in the complete or partial abandonment of other important alternative forms of enjoyment and interests in order to use the substance, or in the fact that a lot of time is spent on activities related to the acquisition and use of the substance and recovery from it. effects.
E) Continued use of the substance despite clear evidence of harmful effects, as evidenced by chronic use of the substance with actual or perceived understanding of the nature and extent of the harm.
A narrowing of the repertoire of substance use is also considered a characteristic (eg, a tendency to consume alcohol equally on weekdays and weekends despite social disincentives). An essential characteristic of the addiction syndrome is the use of a certain type of substance or the desire to use it. Subjective awareness of craving for psychoactive substances most often occurs when trying to stop or limit their use. Such a diagnostic requirement excludes, for example, surgical patients who are given opiates for pain relief and who may show signs of withdrawal when opiates are stopped, but have no desire to continue taking the drug. The dependence syndrome may be in relation to a particular substance (for example, tobacco or diazepam), a class of substances (for example, opioid drugs), or to a wider range of different substances (the need for some individuals to regularly take any available drugs with the appearance of restlessness, agitation and /or physical signs of abstinence withdrawal).
The diagnosis of dependence syndrome should be clarified by the following five-digit codes:
/F1x.20/ Currently abstinence (remission);
/F1x.21/ Currently abstinence, but under conditions precluding use (under protective conditions);
/F1x.22/ Currently on a maintenance regimen of clinical observation or substitution therapy (controlled dependence);
/F1x.23/ Currently abstinence, but on the background of treatment
By aversive (disgusting) means, or
Drugs that block the action of narcotic and
/F1x.24/ Current substance use (active
/F1х.25/ Systematic (permanent) use;
/F1x.26/ Periodic use;
/F1х.29/ Periodic use NOS.
To code the stage of dependence in the use of psychoactive substances, the sixth character must be used:
F1x.2x1x Initial (first) stage of dependence;
F1x.2x2x Middle (second) stage of dependence;
F1х.2х3х Final (third) stage of dependence;
F1x.2x9x Dependency stage unknown.
Dependence on psychoactive substances is understood as a painful process, naturally passing through successive stages, having its own beginning and end. However, not all stages can be found in the dynamics of dependence on individual psychoactive substances (hallucinogens, tobacco, and others).
F1х.2х1х Initial (first) stage of dependence
The following diagnostic criteria are distinguished (see Criteria
A), b), d) and f) of the "Diagnostic Guidelines" for F1x.2 dependence syndrome), indicating the formation of the initial stage of dependence (two criteria are sufficient for making a diagnosis):
A strong desire or feeling of an overwhelming craving to take a substance;
Decreased ability to control substance use: onset, end or dose, as evidenced by the use of the substance in large quantities and for a period of time longer than intended, unsuccessful attempts or a persistent desire to reduce or control the use of the substance;
Increased tolerance to the effects of a substance, consisting in the need for a significant increase in dose to achieve intoxication or the desired effects, or in the fact that chronic use of the same dose of the substance leads to a clearly reduced effect; continued use of the substance despite clear evidence of harmful effects, as evidenced by chronic use of the substance with actual or perceived understanding of the nature and extent of the harm.
F1x.2x2x Middle (second) stage of dependence
In addition to those signs of dependence, which are indicated in F1x.2x1x, at least one of the two remaining criteria c) and e) of the dependence syndrome is additionally present (see F1x.2-):
Withdrawal or withdrawal syndrome (see F1x.3xx and
F1x.4xx) occurring when the use of a substance is reduced or discontinued as evidenced by the complex of disorders characteristic of that substance or the use of the same (or a similar substance) to alleviate or prevent withdrawal symptoms;
Preoccupation with the use of a substance, which manifests itself in That in order to take the substance, other important alternative forms of enjoyment and interests are completely or partially abandoned, or that a lot of time is spent on activities related to the acquisition and use of the substance and on recovery from its effects.
F1x.2x3x Final (third) stage of dependence
In addition to the signs of the dependence syndrome indicated in F1x.2x1x and in F1x.2x2x, signs of residual mental disorders and mental disorders with a late onset are determined (see F1x.7xx); an increase in tolerance to a psychoactive substance may be replaced by a tendency to decrease it.
In the final stage of dependence, as a rule, persistent somato-neurological disorders are determined (in particular, polyneuropathy, cerebellar disorders, characteristic lesions of the heart, liver and other organs and systems).
F1x.2x9x Dependency stage unknown
/F1x.3/ Withdrawal state (withdrawal syndrome)
A group of symptoms of varying combination and severity that occur when a substance is completely discontinued or its dose is reduced after repeated, usually prolonged and/or high doses of the substance. The onset and course of the withdrawal syndrome is limited in time and corresponds to the type of substance and dose immediately preceding abstinence. The withdrawal syndrome can be complicated by convulsions.
The state (syndrome) of withdrawal is one of the manifestations of the dependence syndrome (see F1x.2xx), and this latter diagnosis also needs to be established.
The diagnosis of dependence syndrome should be coded as primary if it is sufficiently pronounced and is the immediate reason for the referral to a specialist doctor.
Physical impairments may vary depending on the substance used. Psychiatric disorders (eg, anxiety, depression, sleep disorders) are also characteristic of withdrawal syndrome. Usually the patient indicates that the withdrawal syndrome is alleviated by subsequent use of the substance.
It must be remembered that the syndrome (state) of withdrawal can be caused by a conditioned reflex stimulus in the absence of immediately preceding use. In such cases, the diagnosis of withdrawal syndrome is made only if it is justified by the sufficient severity of the manifestations.
Many of the symptoms present in the structure of the withdrawal syndrome (state) can also be caused by other mental disorders, such as anxiety, depressive disorders, and others. A simple post-toxic state ("hangover") or tremor caused by other causes should not be confused with withdrawal symptoms.
The following diagnostic criteria are distinguished:
G1. There must be clear evidence of recent discontinuation or dose reduction of the substance after using the substance, usually for a long time and/or at high doses.
G2. The symptoms and signs correspond to the known characteristics of the withdrawal state of the particular substance or substances (see below under the relevant subheadings).
G3. The symptoms and signs are not due to a medical disorder unrelated to the use of the substance and cannot be better explained by another mental or behavioral disorder.
The diagnosis of the cancellation condition must be clarified by the appropriate five-digit codes.
F1x.30x Withdrawal state (withdrawal syndrome), uncomplicated
F1x.31x Withdrawal state (withdrawal syndrome) with convulsive seizures
For some groups of psychoactive substances with anticonvulsant activity, such as barbiturates, for example, seizures are one of the typical manifestations of the state of withdrawal.
F1х.39х Withdrawal state
(withdrawal syndrome) NOS
F1x.3xx Particular forms of withdrawal symptoms
This subsection uses the diagnostic features specific to each of the psychoactive substances listed below.
F10.3x Alcohol withdrawal syndrome
(alcohol withdrawal state)
When using this code, the following diagnostic rules apply:
Some of the following may be present: desire to drink alcohol; tremor of the tongue, eyelids, or outstretched arms; sweating; nausea or vomiting; tachycardia or arterial hypertension; psychomotor agitation; headache; insomnia; feeling unwell or weak; episodic visual, tactile, auditory hallucinations or illusions; grand mal seizures; depressive and dysphoric disorders.
If delirium is present, the diagnosis should be "alcohol withdrawal with delirium" (F10.4x).
F11.3x Opioid withdrawal syndrome
Must meet the general criteria for a withdrawal state (F1x.3) (Note that opioid withdrawal can also be induced by opioid antagonists after a short period of opioid use.).
Symptoms from the following may be present:strong desire-
Don't take opioids; rhinorrhea or sneezing; lacrimation; muscle pain or cramps; abdominal cramps; nausea or vomiting; diarrhea; pupil dilation; the formation of "goose bumps", periodic chills; tachycardia or arterial hypertension; yawn; restless sleep; dysphoria.
F12.3x Cannabinoid withdrawal syndrome
It is an ill-defined syndrome for which specific diagnostic criteria cannot currently be established.
It develops after the cessation of long-term use of cannabis in high doses.
Its symptoms include asthenia, apathy, hypobulia, decreased mood, anxiety, irritability, tremors, and muscle pain.
F13.3xx Sedative or hypnotic withdrawal syndrome
When using this code, the following diagnostic rules apply:
Must meet the general criteria for abort condition (F1x.3).
Symptoms from the following may be present: tongue tremor,
Eyelids or outstretched arms; nausea or vomiting; tachycardia; postural
hypotension; psychomotor agitation; headache; insomnia;
Feeling unwell or weak; episodic visual, tactile, auditory hallucinations or illusions; paranoid mood; grand mal seizures; dysphoria; desire to take sleeping pills or sedatives.
If delirium is present, the diagnosis should be Sedative or Hypnotic Withdrawal Condition with Delirium (F13.4xx).
F14.3x Cocaine withdrawal syndrome
When using this code, the following diagnostic rules apply:
Must meet the general criteria for abort condition (F1x.3).
There is a disturbed mood (eg, depression and/or anhedonia).
Symptoms from the following may be present: Apathy and asthenia; psychomotor retardation or agitation; strong desire to take cocaine; deep, close to lethargic, sleep; increased appetite; insomnia or hypersomnia; bizarre or unpleasant dreams.
F15.3xx Syndrome of withdrawal of other stimulants
When using this code, the following diagnostics apply:
Must meet the general criteria for abort condition (F1x.3).
There is a disturbed mood (eg, depression and/or anhedonia).
Symptoms from the following may be present: Apathy and asthenia; psychomotor retardation or agitation; a strong desire to take stimulants; increased appetite; insomnia or hypersomnia; bizarre or unpleasant dreams; deep, close to lethargic sleep.
F16.3xx Hallucinogen withdrawal syndrome
F17.3x Tobacco withdrawal syndrome
When using this code, the following diagnostic rules apply:
Must meet the general criteria for abort condition (F1x.3).
Symptoms from the following may be present: strong desire-
Do not use tobacco (or other nicotine containing products); feeling unwell or weak; dysphoria; irritability or anxiety; insomnia; increased appetite; coughing; difficulty concentrating.
F18.3xx Volatile solvent withdrawal syndrome
There are currently no defined diagnostic criteria for this condition.
F19.3xx Multidrug withdrawal syndrome
This is a diverse combination of symptoms, depending on the types of psychoactive substances used.
/F1x.4/ Withdrawal state
(withdrawal syndrome) with delirium
Withdrawal syndrome (see F1x.3) complicated by delirium (see criteria for F05.-).
This refers to a short-term (transient), caused by psychoactive substances (mainly alcohol and some others), sometimes a life-threatening acute psychotic state, occurring with a disorder of consciousness, hallucinations and concomitant somatic disorders. It usually occurs as a result of the complete or partial cessation of the substance in people who are addicted to it and use the substance for a long time. In cases where delirium occurs at the exit from a severe kurtosis, it is also encoded in this paragraph.
Prodromal symptoms typically include insomnia, tremors, anxiety, and fear. Seizures may occur before onset. The classic triad of symptoms includes disturbance of consciousness, vivid hallucinations and illusions affecting any sphere of the senses, and severe tremor. Delusions, agitation, insomnia or sleep cycle inversion, and autonomic disturbances are also commonly present.
When using this code, the following diagnostic rules apply:
Presence of a canceled state, as defined in /F1x.3/.
The presence of delirium as defined in /F05.-/.
Delirium tremens (alcoholic) (F10.4x);
Encephalopathy Gaye-Wernicke (F10.4x);
Encephalopathy of Marchiafava-Bignami (F10.4x);
Other acute alcoholic encephalopathies (F10.4x).
Delirium not caused by alcohol or other psychoactive substances (F05.-);
Chronic encephalopathies caused by the use of psychoactive substances (F1x.73x).
The diagnosis of withdrawal syndrome with delirium should be specified by the fifth character, depending on the form (type of flow) of delirium.
F1x.40x Withdrawal (withdrawal syndrome) with delirium ("classic" delirium)
F1x.41x Withdrawal state (withdrawal syndrome) with delirium with convulsive seizures
F1x.42x Withdrawal state (withdrawal syndrome) with exacerbating delirium ("mumbling" delirium)
F1x.43x Withdrawal state (withdrawal syndrome) with "professional delirium"
F1x.44x Withdrawal state (withdrawal syndrome) with delirium without hallucinations (lucid)
F1x.46x Withdrawal state (withdrawal syndrome) with abortive delirium
F1x.48x Withdrawal state (withdrawal syndrome) with delirium, other
F1x.49x Withdrawal state (withdrawal syndrome) with delirium, unspecified
/F1x.5/ Psychotic disorder
A disorder that occurs during or immediately after substance use, characterized by vivid hallucinations (usually auditory, but often involving more than one sensory area), false recognitions, delusions and/or ideas of attitude (often of a paranoid nature), psychomotor disturbances (agitation or stupor), an abnormal affect that ranges from intense fear to ecstasy. Consciousness is usually clear, although some degree of confusion is possible. The disorder usually resolves at least partially within 1 month and completely within 6 months.
A psychotic disorder occurring during or immediately after substance use should be reported here unless it is a manifestation of withdrawal with delirium (see F1x.4xx) or late-onset psychosis. Psychotic disorders may occur with a late onset (more than 2 weeks
after substance use), but they should be coded as
Psychotic disorders caused by substance use can vary in their symptoms. It depends on the type of substance used and the personality of the user. With the use of stimulant drugs such as cocaine and amphetamines, psychotic disorders are usually caused by high doses and/or long-term use.
When taking substances with a primary hallucinogenic effect (LSD, mescaline, high doses of hashish), the diagnosis of a psychotic disorder should not be based solely on the presence of a perceptual disorder or hallucinations. In such cases, as well as in states of confusion, the diagnosis of acute intoxication (F1x.0xx) should be considered.
Particular care should be taken to rule out the possibility of misdiagnosis of another disorder (eg, schizophrenia) when a diagnosis of substance-induced psychosis is appropriate. In most cases, when psychoactive substances are stopped, these psychoses are of short duration (for example, psychoses caused by amphetamine and cocaine). False diagnoses in such cases lead to negative moral and material consequences for both the patient and the health service.
The possibility of other psychotic disorders aggravated or accelerated by drug use should be considered: for example, schizophrenia (F20.-), affective disorders (F30 - F39), paranoid or schizoid personality disorder (F60.0x; F60.1x). In such cases, the diagnosis of a substance-induced psychotic disorder would be incorrect.
Psychotic disorder can occur at any stage of addiction, but predominantly in the middle and final stages.
When using this code, the following diagnostic rules apply:
Psychotic symptoms develop during the use of the substance or within 2 weeks after taking it.
Psychotic symptoms persist for more than 48 hours.
Acute alcoholic hallucinosis;
Alcoholic delirium of jealousy (initial period);
Acute alcoholic paranoia;
Alcoholic psychosis NOS.
Subacute alcoholic hallucinosis (F10.75);
Chronic (recurrent) alcoholic hallucinosis (F10.75);
Alcoholic delirium of jealousy (F10.75);
Alcoholic or other psychoactive substance-induced residual and delayed psychotic disorders (F10 - F19 with a common fourth character. 7).
The diagnosis of a psychotic disorder should be specified by the fifth digit according to the leading psychotic syndrome.
F1x.50x Schizophrenia-like disorder
F1x.51 Predominantly delusional disorder
The initial period of delirium of jealousy.
Remote period of delirium of jealousy (F1x.75x).
F1x.52 Predominantly hallucinatory disorder
(includes alcoholic hallucinosis)
F1x.53 Predominantly polymorphic psychotic disorder
F1x.54 Disorder with predominantly depressive psychotic symptoms
F1x.55 Disorder with predominantly manic psychotic symptoms
F1x.6x Amnestic syndrome
Syndrome associated with chronic severe impairment of memory for recent events: memory for distant events is sometimes impaired, while immediate recall may be preserved. There is usually a disturbance in the sense of time and order of events, in severe cases leading to amnestic disorientation, as well as the ability to assimilate new material. Confabulations are possible, but not required. Other cognitive functions are usually preserved, and memory defects are disproportionately large relative to other impairments.
Amnestic syndrome due to alcohol or other psychoactive substances must meet the general criteria for an organic amnestic syndrome (see F04.-).
Personality changes may also be present, often with the onset of apathy and loss of initiative (tendency to not take care of oneself), but these should not be considered indispensable for a diagnosis.
Amnestic syndrome occurs predominantly in the final stage of dependence on psychoactive substances (as an outcome of acute encephalopathies).
When using this code, the following diagnostic rules apply:
Memory impairment, manifested by two signs:
1) impaired memorization and memory defect for recent events (impaired assimilation of new material) to a degree sufficient to cause difficulties in everyday life, up to amnestic disorientation;
2) reduced ability to reproduce past experience.
Absence (or relative absence) of the following features:
1) obscuration of consciousness and disorders of attention, as they are defined by the criterion
2) general intellectual decline (dementia).
Absence of objective data (physical and neurological examination, laboratory tests) and/or anamnestic information about brain disease, other than alcoholic encephalopathy, that could reasonably be considered the cause of clinical manifestations in accordance with the criteria for memory impairment described above.
Consideration should be given to the possibility of an organic (non-alcoholic) amnestic syndrome (see F04.-); other organic syndromes, including severe memory impairment (eg dementia or delirium) (F00-F03, F05.-), depressive disorder (F31-F33).
Amnestic syndrome due to alcohol or other psychoactive substance;
Amnesic disorder due to alcohol or drugs;
Korsakoff's psychosis or syndrome induced by alcohol or other psychoactive substance, or unspecified.
Non-alcoholic and non-drug-induced Korsakoff's psychosis or syndrome (F04.-).
/F1x.7/ Residual and delayed
Substance-induced disorders characterized by changes in cognition, personality, or behavior that continue beyond the period of direct effect of the psychoactive substance.
The occurrence of the disorder must be directly related to the use of the substance.
The disorder must continue beyond the period of direct exposure to the psychoactive substance (see F1x.0x, acute intoxication). Substance-induced dementia is not always permanent, and after a long period of complete abstinence, intellectual function and memory may improve.
The disorder must be distinguished from conditions associated with withdrawal (see F1x.3xx and F1x.4xx). It must be remembered that, under certain conditions and types of psychoactive substance, withdrawal may occur for many days or weeks after stopping the substance.
Substance-induced and persisting post-use conditions that meet the diagnostic criteria for psychotic disorders should be classified in F1x.5xx (psychotic disorder). Chronic end states of Korsakoff's syndrome should be coded in F1x.6x.
Residual effects can be distinguished from the psychotic state (as defined in F1x.5xx) in part by their episodic nature, predominantly of very short duration, duplicating prior manifestations of substance use.
Consideration should be given to the possibility of pre-existing psychiatric disorders masked by substance use and recurring during the period of withdrawal of alcohol or drug effects (eg, phobia-related anxiety, depressive disorder, or schizotypal disorder). Consider acute transient psychotic disorder (F23.-) in case of spontaneous recurrence of intoxication pattern. Also be aware of organic damage and mild or moderate mental retardation (F70 - F71), which may be associated with substance abuse.
Alcoholic dementia NOS;
Mild forms of persistent cognitive impairment;
Perceptual disturbance after the use of a hallucinogen;
Residual emotional (affective) disorder;
Residual personality and behavior disorder.
Alcoholic or drug-induced Korsakoff's psychosis or syndrome caused by alcohol or other psychoactive substances (F10
F19 with a common fourth character.6);
Alcoholic or narcotic psychotic state (F10 - F19 with a common fourth character.5).
This diagnostic rubric is subdivided by the following five-digit codes according to the leading mental disorders.
Spontaneous short-term relapses of symptoms of acute intoxication in the absence of actual substance use. It occurs at any stage of dependence on a psychoactive substance.
F1x.71x Personality and behavior disorder
When using this code, the following diagnostic rules apply:
Specific personality changes accompanied by social maladaptation.
Meets the general criteria F07.- ("Personality and behavioral disorders due to disease, damage or dysfunction of the brain").
F1x.72x Residual affective disorder
When using this code, the following diagnostic rules apply:
Persistent non-psychotic emotional and volitional disorders (blunting of higher feelings, coarseness, irritability).
Meets general criteria F06.3- ("Organic mood disorders (affective disorders)").
The general criteria for dementia (F00 - F03) are met.
Chronic encephalopathy caused by the use of psychoactive substances.
F1x.74 Other persistent cognitive impairment
When using this code, the following diagnostic rules apply:
Persistent intellectual-mnestic decline, not reaching the degree of dementia.
Criteria F06.7- ("Mild cognitive impairment") are met, except for criterion G. which excludes the use of a psychoactive substance.
F1x.75x Late onset psychotic disorder
When using this code, the following diagnostic rules apply:
The general criteria for F1x.5x must be met, except that the disorder occurs more than two weeks after the substance has been taken and continues for more than 6 months.
Chronic (recurrent) alcoholic hallucinosis;
Delirium of jealousy (remote period).
The initial period of delirium of jealousy (F1x.51x).
/F1x.8/ Other mental disorders and
Any other disorders where substance use is identified as directly affecting the patient that do not meet the criteria for the disorders listed above are coded here.
F1x.81x Other psychotic disorders
Any other psychotic disorders where substance use is identified as having a direct effect on the patient's condition and not meeting the criteria for the psychotic disorders listed above are coded here.
F1x.82x Other non-psychotic and behavioral disorders
Any other non-psychotic disorders and
Conduct disorders where substance use is identified
As directly affecting the patient's condition, not responding
Criteria The above non-psychotic disorders and races
/F1x.9/ Mental disorder
And conduct disorder, unspecified
Differentiation of these disorders should take into account the possibility of pre-existing psychiatric disorders masked by substance use and recurring during the period of withdrawal of alcohol or other psychoactive substances (eg, phobia-related anxiety, depressive disorder, or schizotypal disorder).
F1x.91x Unspecified psychotic disorders
Psychosis NOS due to substance use.
F1x.92x Unspecified non-psychotic and behavioral disorders
Substance use non-psychotic disorder NOS.
F1x.99x Unspecified mental disorders
Psychiatric disorder NOS due to substance use.
Unfortunately, the vast majority of people prefer to ignore the symptoms of the onset of the disease. We are so used to the idea of our own invulnerability that every cold becomes a real surprise, and even a more serious diagnosis turns out to be a bolt from the blue. Here are some subtle, but very dangerous signs that you are quietly losing health.
Weight loss
If you have lost more than five kilograms in a short time, without dieting and exercising, then you should consult a doctor. This is one of the signs of cancer of the pancreas, esophagus and lungs. People, unfortunately, easily ignore weight loss, blaming everything on external causes.
Dental problems
Worn enamel is often a sign of acid reflux, an unpleasant and complex illness. Acids from the esophagus dissolve the enamel on the back of the teeth - unlike sugary drinks, which attack the front. If you notice this problem, contact your doctor immediately. Without treatment, acid reflux not only leads to tooth decay, but also greatly increases the risk of developing esophageal cancer.
Itching and rash on the skin
Painful rashes on the knees, elbows and scalp look exactly like eczema. However, this can be a much more serious problem. Celiac disease, an autoimmune disease, causes exactly these symptoms. You may have to give up gluten-containing foods forever.
Bowel and genitourinary disorders
Too frequent urination can signal either bladder problems or advanced prostate cancer. Constipation or diarrhea are signs of colon disease. Of course, both may well be caused by external causes, however, if the ailment lasts more than a week, you should not postpone going to the doctor.
handwriting change
Parkinson's disease means the death of nerve cells in the brain. The worst thing is that the patient does not notice any drastic changes and does not resort to diagnostics. However, studies have made it possible to prove the correlation between the patient's inconsistent handwriting and the disease. The brain stops producing dopamine, a chemical that sends signals to the limbs to move. This causes stiffness in the muscles of the hands, which affects handwriting. Other markers of an upcoming illness are a sudden loss of smell and very intense dreams.
sudden anger
More than half of patients suffering from severe depression are prone to fits of sudden anger. Such a problem cannot be cured with drugs alone: you will need to work with a cognitive psychologist. If you notice that for two weeks in a row you are breaking down over trifles, then you should seek advice. Running depression may well develop into obsessive-compulsive disorder.
Persistent cough
As a rule, a cough does not mean cancer at all. However, prolonged bouts of coughing for no apparent reason - colds, allergies, asthma - is already a reason to be wary. Unfortunately, it can signal advanced lung cancer. Accompanied by hoarseness - cancer of the throat and larynx. We recommend that you have cancer screenings at least once a year.
We often say the phrase: “All diseases are from nerves!”. How does modern medicine relate to this statement? In February 2016, a scientific conference of psychotherapists and psychiatrists was held in St. Petersburg, where this problem was discussed. The trouble is that both in Russia and all over the world the number of neuroses and borderline mental disorders is growing. According to experts, about 70% of Russians have various neurotic disorders. Residents of big cities are especially prone to neuroses: the pace of life, psychological stress at work and at home, and economic problems also affect. What is neurosis Neurosis is a nervous disease, expressed in the fact that a person cannot adapt to the real conditions of life and begins to respond to them inadequately. For example, in a neurasthenic neurosis, it seems to the patient that he is weak, very ill, and unfavorable circumstances are constantly developing around him. Main symptoms: headache, pain in the heart. Without outside help, such a painful reaction of the nervous system can lead to serious chronic diseases. With hysterical neurosis, a person can feel pain in various organs, including "paralysis" of the legs or arms, "deafness", "blindness". These "symptoms" essentially serve to draw attention to oneself and manipulate others, and sometimes even unconsciously. Experts believe that neuroses arise not because of unpleasant events, but because of a person’s attitude towards him. Of course, neurosis cannot lead to disability and death, but it seriously reduces the quality of life. Recently, increased anxiety has become one of the main signs of neurosis. Neurosis is manifested by sleep disorders and various phobias, a “traditional” phobia is the fear of death or a serious illness. In our technological age, many people suffer from aerophobia, the fear of flying on an airplane, we are not talking about those who are afraid, but cope with their fear and excitement. There are people who refuse to fly in principle. What is a psychosomatic illness? The term "psychosomatics" is composed of two Greek words (psyche - soul, soma - body). Psychosomatic disease is a disease of the body caused by psychological causes, when bodily symptoms are a kind of "escape to the disease" from life's problems. F. Alexander, an authoritative psychotherapist from the USA, compiled a list of seven such diseases: Hypertension Gastric and duodenal ulcer Nonspecific ulcerative colitis Bronchial asthma Rheumatoid arthritis Neurodermatitis Thyrotoxicosis (thyroid disease) Many experts believe that a psychological cause can be found in any disease. Psychosomatic disorders include up to five hundred diseases. The direct influence of the nervous system has also been proven in the development of such painful conditions as dizziness, irritable bowel syndrome, tension headache. We ourselves have encountered such situations: on the eve of an important test, a child has a fever, or we have to cancel a business meeting due to a sudden cold or a domestic injury. Many psychotherapists explain such coincidences with a sudden decrease in immunity, in this way the body protects itself from the expected heavy burden on the psyche. According to the statistics of the World Health Organization, about 40% of patients who come to the doctor suffer from psychosomatic diseases. How the nervous system affects the work of all body systems can be traced under stress. Typical reactions to a stressful situation: Increased blood pressure. The heart begins to beat faster and stronger. Increased muscle tone. Blood flow to the brain, heart, and muscles is increased. Internal organs receive less blood due to vasospasm. As a result, the body enters a state of tension and excitement “for nothing”, and the accumulated negativity has nowhere to go, except to transfer it to an innocent loved one, leading to stress. Repeated rocking of all systems and organs ultimately leads to disruption of their work, first temporary, and with frequent stress - and to a permanent "real" diagnosis. How to avoid diseases from nerves? If possible, avoid conflicts, if not, get out of them peacefully. Do not hesitate to contact a psychologist, do not wait for serious health problems. Sleep at least 7-8 hours a day, constant lack of sleep is a strong stress for the body. Be outdoors more often, travel. Try to observe the regime of the day, eat at a certain time, plan your classes. In addition to work, it is very useful to engage in creativity and physical education. We work to live, not the other way around! With increased nervous stress (children entering school, problems with loved ones, moving to a new job, an urgent and difficult production task), take vitamins and health products to support the nervous system. There are many health products, one of the modern options is the DOCTOR SEA series, developed by domestic scientists. Complexes IMMUNOSTIMUL and EXTRA YOUTH - DOCTOR SEA are made from marine raw materials, they help to strengthen the nervous system, maintain immunity, and reduce the severity of the reaction to stress. IMMUNOSTIMUL reduces the level of anxiety, protects the body from the damaging effects of the external environment. EXTRA YOUTH also improves the condition of the skin, normalizes the metabolism and functions of the endocrine glands, serves as a source of essential vitamins, macro- and microelements. Even if all diseases are really "from the nerves", these products will strengthen your nervous system and health.
nephrolithiasis- what it is, every tenth person in the world knows firsthand. Periodic sharp pains in the lumbar region or in the side, difficulty urinating, bouts of nausea and vomiting make a person's life unbearable, they force him to lie under the surgeon's knife. Often our diet is to blame for the formation of kidney stones. Let's name 7 products, the exclusion of which from the daily menu will significantly reduce the risk of developing an ailment.
1. Sorrel
Rhubarb, sorrel and spinach. What do these products have in common? Each of them contains an abundance of oxalic acid. 70% of kidney stones are deposits of salts of this particular acid - oxalates. These are the most problematic formations. They are practically insoluble and have numerous spikes and sharp edges that damage the lining of the urinary tract and cause blood in the urine. In addition to stewed rhubarb and boiled spinach, oxalic acid is present in large quantities in cocoa powder and beets. So lovers of chocolate are at risk of a dangerous disease.
2. Sprats
The abuse of protein foods rich in purine bases leads to the formation of another type of kidney stones - urates(meet in 10-15% of cases). The fact is that in the process of a chain of transformations, purines are converted into uric acid, which is removed from the body by the kidneys. If the latter, for one reason or another, do not cope with their task, the concentration of uric acid in the blood, as they say, rolls over.
Crystals begin to form in the joints, kidneys, and even under the skin. Developing nephrolithiasis. Purines are found in abundance in offal (liver, lungs, heart, animal kidneys), as well as chicken. But the undisputed leader in this matter is sprats (222 mg of purines per 100 g). By the way, when cooking, about half of the purines contained in the product goes into the broth.
3. Artificial sugar substitutes
This product is most often eaten by those who want to lose weight or keep their blood sugar levels under control. Few people know, but sweeteners have a strong acid-forming effect. To protect itself from the destructive influence of oxidative phenomena (acids corrode cell membranes), the body seeks to neutralize them. How? First with sodium, but macronutrient supplies quickly run out. The next buffer in line, restoring the acid level to normal levels, is calcium- a mineral with a significant alkalizing effect. It is taken from bones and teeth and released into the blood. A high concentration of calcium in the blood leads to an increase in the amount of mineral deposits in the kidneys and the formation of stones.
4. Salt
nephrolithiasis may be the result of a love of excessively salty foods. The fact is that an excess of sodium chloride - as chemists call table salt - causes fluid retention in the body (1 g of sodium retains 200 ml of water), thickening of the blood and impaired physiological excretion of urine. The stagnation of the latter, as you know, leads to its thickening, creates an additional load on the kidneys that filter urine and contributes to the formation of stones. The maximum allowable salt intake per day is 2 g.
5. Wheat bread
Here you need to name: sweets, white rice, pasta, cookies, beer, sweet white wine. These goodies contain purified - organic substances, freed from all "superfluous", that is, from fiber, vitamins and minerals. Such carbohydrates are quickly processed by the body and enter the blood just as rapidly, causing spikes in sugar levels and fluctuations in insulin concentration.
The pancreatic hormone has the ability to increase the body's reabsorption of sodium from the urine. This is accompanied by increased reabsorption of uric acid in the kidneys. We already know what the high concentration of the latter in the blood leads to. With a tendency to stone formation in the kidneys, refined carbohydrates must be replaced with unrefined ones. These are found in brown rice, oatmeal, legumes, millet, barley, lentils, poultry meat.
Not only do the lion's share of them contain sugar substitutes, the dangers of which we wrote above, but manufacturers also add orthophosphoric acid (E 338) to such drinks as a stabilizer and acidity regulator. But it affects not only the acidity of the drink, but also the acidity of our body, increasing it. What this leads to, we have already written above. But that's not all: an excess of E338 in the blood provokes the formation phosphate stones in the kidneys, which are dangerous because they can rapidly increase in size and cause a large number of complications.
7. Skimmed milk powder
This product is the leader in calcium content. The named macronutrient is extremely important for the normal functioning of the whole organism. The work of the muscular apparatus, the condition of the teeth, hair and nails largely depend on it. This is provided that the hormonal balance of the body is not disturbed, and specifically, enough testosterone. The fact is that the sex hormone stimulates the birth of bone tissue cells that renew it and use calcium for construction work.
And remember: kidney stone disease cannot be defeated without revising your traditional diet, since one of the main reasons for the development of pathology is hidden in it.
HEALTH NEWS:
ALL ABOUT SPORT
Athletes-vegetarians today are of little surprise. Many sports stars consciously choose this path and only win. Much more surprising is the fact that this practice existed long before vegetarianism became mainstream. The great athletes of the past basically refused meat, but at the same time they continued to beat record after record. Who are these heroes, and in what ...
my anxiety disorder
what is this diagnosis: 7b 22? need decryption.
A good text about what 7b is dpmmax.livejournal.com/482698.html
In the modern interpretation of the Schedule of Diseases, Article 7b means a fungal disease - dermatophysis.
DIAGNOSIS 7B - HOW TO DECRYPT??
What does diagnosis 7B mean?
Is it possible to cancel it.
For my eighteenth birthday, my mother gave me a white ticket without asking my consent.
Your question is for specialists working in Ukraine. They know the guidelines for military medical expertise adopted in your country.
Sincerely, Victor
Counseling for "primary psychotic episodes", chronic mental illness
Conducting training seminars - trainings in psychotherapy
Citizens suffering from microsporia, trichophytosis are subject to treatment. When called up for military service or entering military service under a contract, they are recognized as temporarily unfit for military service for up to 6 months.
Soldiers suffering from dermatophytosis are subject to treatment. Upon completion of treatment, they are considered fit for military service.
The diagnosis of mycosis must be confirmed by laboratory testing.
God bless you never have a reason to go to the doctor! And if you have to, then do not delay.
which means st.7b (psychiatry).
Psychopathy (from the Greek psyche - soul and pathos - suffering, illness) - inadequate development of emotional and volitional character traits of a person, to a large extent determined by congenital inferiority of the nervous system (encephalitis, head injury). Psychopaths are distinguished primarily by the inadequacy of emotional experiences, a tendency to depressive and obsessive states.
There are the following types of psychopathy:
1. Asthenic, which is characterized by increased irritability and rapid exhaustion;
2. Excitable, which is characterized by inadequacy of emotional reactions with violent outbursts of anger;
3. Hysterical, which is characterized by impressionability, suggestibility, egocentrism;
4. Paranoid, which is characterized by suspicion, high self-esteem, a tendency to overvalued ideas.
Psychiatrist → Consultations
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"7-B" - according to the old classification - this is psychopathy (an anomaly of character). Psychopathy (character anomaly, personality anomaly, psychopathic constitution, pathological character) is a persistent congenital personality disharmony. Preim appears. inadequate behavior and lack of social adaptation. Formed in childhood or adolescence, during life, disharmony of character can intensify or develop in a certain direction under the influence of various factors and circumstances, but never reaches the degree of pronounced mental disorders. Most psychopaths show signs of mental and physical infantilism of varying severity. Disharmony manifests itself. arr. in the volitional and emotional spheres, the intellect is not impaired in psychopathy.
The diagnosis hidden behind the code F83 - Mixed specific disorders of psychological (mental) development. This is not quite a diagnosis, and even more so, far away.
There are no contraindications for IVF by a man.
Hello! Not only possible, but necessary. Based on the testimony of your father, he will be sent for involuntary hospitalization and treatment.
Hello! This disease is not a mental disorder and with the right approach to treatment, the child's speech can gradually recover. More.
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Psychology Forum
Simulation of mental illness
12 Jul 2008
The difficulty of identifying feigned psychoses has long been recognized. Rosenhan's (1973) classic study, which is probably the best-known study of feigned psychosis, showed psychiatrists' inability to distinguish normal from pathological. Eight voluntary “pseudo-patients” (among them one psychology student, three psychologists, a pediatrician, a psychiatrist, an artist and a housewife) were secretly admitted to a psychiatric hospital complaining of having “voices”. These complaints ceased immediately upon admission to the hospital. All were diagnosed with schizophrenia. The length of stay in the hospital ranged from 9 to 52 days. It should be noted that other patients sometimes identified sham "pseudo-patients". Rosenhan came to this conclusion: “It is clear that in the setting of psychiatric hospitals we cannot distinguish a mentally healthy person from a patient with mental disorders.” These difficulties are partly due to the fact that psychiatry is far from being an exact science, instead of accurate biological markers, diagnosis is based on clinical observation and subjective interpretation of symptoms.
Simulation should be suspected if any of the following are present:
2. crazy ideas:
16 Jul 2008
16 Jul 2008
16 Jul 2008
17 Jul 2008
Indeed, thanks to Mirror for interesting articles, even with links. It looks very plausible at first glance.
about how schizophrenia is diagnosed, you can search on Google, it's all a myth that there is purely the opinion of a psychiatrist doctor, there is a very clear program and criteria that should at least be confirmed, as well as all other diseases similar in symptoms should be checked (for example - psychosis). Also, a picture of the brain is taken and analyzed in mental patients for problems with the release of substances that affect emotionality and which can be quite specifically and scientifically diagnosed. Human emotions are chemistry in the body
17 Jul 2008
08 Aug 2008
Guest_VMR_* 27 Aug 2008
in particular, revealing a simulation of a mental disorder induced by the mother in a minor child of 11 years old. Including with the help of a comprehensive forensic psychological and psychiatric examination. But will respected and competent interlocutors agree to discuss this issue?
27 Aug 2008
28 Aug 2008
Including with the help of a comprehensive forensic psychological and psychiatric examination.
If the examination confirmed, then I think there is nothing to talk about, most likely it is. But you can still, just in case, try to drive around private traders, maybe they will somehow refute.
As for a more detailed diagnosis, more information is needed, and everything that you know is better. The diagnosis is one thing, but on the basis of what it was made, that is the question.
Guest_VMR_* 28 Aug 2008
28 Aug 2008
The case is quite unusual, if not exclusive.
28 Aug 2008
The first thought is that it is time to treat this mother herself.
and terminate parental rights
Guest_VMR_* 28 Aug 2008
Sick Monkey 30 Aug 2008
31 Aug 2008
In order not to follow the call, it was enough, as we said then, “seven”. 7 B - code for a disease called "psychopathy". If we take a reference book on psychiatry edited by academician Snezhnevsky, we will read the following: "Psychopathy is a violation of adaptation due to pronounced pathological personality traits, their totality and low reversibility." classic definition. How is this condition different from psychosis, such as schizophrenia or TIR? The fact that it does not have a progression - the course, the development of the disease, the dynamics. Someone was born and raised with a number of maladaptive traits. They practically do not change during life. There is no deterioration in the picture of the disease, but a healthy person is not considered. I studied all this lofty theory in a week and a half, surrounded by special literature, and went to the people in white coats already fully armed.
stared out the window at the starry Pisces,
shifting bald nape,
in the place where the phlegm is on the floor.
Where fish is sometimes served at the table,
but they don’t give a knife and fork to fish.”
And therefore, having returned to ordinary life and enrolling in the Faculty of Psychology of Moscow State University, I continued to study the history of psychiatry, trying to trace how its fundamental concepts were formed, what concept of a person underlies it. I tried to answer the question: how does a modern psychiatrist think and what determined exactly this and not another way of thinking? For a psychiatrist, when looking at a patient, something becomes obvious. And what cultural processes underlie this “evidence” and shape it? Questions like these lie outside of psychiatry itself; we find ourselves, rather, in the realm of cultural history and the social sciences. In order to comprehend psychiatry as a cultural phenomenon, the means of psychiatry itself are not enough, and going beyond its boundaries for a physician is, in principle, impossible. Medicine does not pose such problems.
One of the most powerful research experiences was associated with reading the books "The Birth of the Clinic" and "The History of Madness in the Classical Age" by Michel Foucault. The latter is by no means a psychiatrist, but his reflections turned out to be extremely valuable.
So, if psychiatric treatment is a repressive practice, then what is illness? Rather, the status, rather than the real condition of the patient. For example, what is schizophrenia? Brain research reveals little. It is not possible to give an exhaustive description of schizophrenia in the language of neurophysiology. And besides, is it one syndrome or several different ones? Dont clear. Then on what basis do we assert something about illness? But you can approach the issue differently. I argue that the content of the concept of "schizophrenia" is reduced to a combination of diagnostic methods and methods of treatment. There is nothing else behind this concept. Such logic goes back to the operationalism of P. Bridgman (a prominent scientist, Nobel laureate in physics), who in 1927 proposed a curious idea of overcoming the crisis in physics. According to Bridgman, the actual content of physical concepts is reduced to a set of experimental operations, more precisely, to a set of measurement operations. For example, what is length? The concept of length is meaningful if the operations by which the length is measured are fixed. The concept of length, strictly speaking, does not contain absolutely anything other than the totality of operations by which the length is determined. Or - the concept of "time". The clock is not a device that determines time, but, on the contrary, time itself is what is measured with the help of a clock.
But one day a serious threat loomed over me again. I was not guilty of anything, but I was persecuted by law enforcement agencies. Then, in the 90s, there was Yeltsin's famous decree "30 days" - a whole month a person could be kept in custody without charge. And get the right evidence. Article 7B (psychopathy), which I had, exempted from the army, but not from criminal liability. I had to go back to the hospital to get a more serious diagnosis - schizophrenia. And unfavorably flowing. This scenario is immeasurably more difficult to play. But it was worth it. After all, if a person has left a psychiatric hospital and he has a referral to VTEK, then the law cannot do anything with him. Moreover, with the goodwill of the doctor, even the interrogation of the patient is impossible. And this is another evidence that psychiatry is just an alternative to the penitentiary system. If you apply to this system yourself, then you are protected from police attacks. And I turned to the famous 15th hospital on Kashirka, where I lay for several months. I even traveled from there to take exams at Moscow State University and successfully passed them. According to the symptoms that I presented to the doctors, I had a high probability of exacerbation. I was heavily treated. I spit the pills down the toilet, but at the same time I talked with friends from the Serbsky clinic, who told me how these pills should work, and I imitated their action. The result was a good diagnosis. It was approved for me by a professor from the Serbsky Institute with a work experience of forty years. He was considered the "luminary" of psychiatry. "Svetilo" gave me the necessary diagnosis without any hesitation. When the representatives of the law discovered that not only did I have malignant schizophrenia in my medical history, but also a referral for disability, they quickly fell behind me. The piquancy of the situation was also in the fact that, having received the necessary diagnosis, I immediately got a job as a psychologist in one of the famous Moscow lyceums. All this happened in 1997. Subsequently, I calmly graduated from the university, graduated from graduate school, and then began to teach at the Faculty of Philosophy of Moscow State University. I'm currently writing a book about MPD - multiple personality disorder.
31 Aug 2008
We were driven out into the corridor in the morning, and it was already impossible to enter the ward until the lights out. I had to pointlessly and monotonously walk along the corridor from wall to wall and smoke cigarette after cigarette.
It's just heavenly relief. Usually, cigarettes are completely withdrawn and exactly 6 cigarettes are given out per day. They "take care" of our health in such a way that at least immediately die from the continuous withdrawal of the smoker.
I say one thing, but an experienced doctor, a recognized specialist, a seemingly educated person, hears and understands something completely different. In everything I say, he a priori sees only the symptoms of the disease, nothing more.
This was also mentioned more than once on the forum - "your every word will be perceived as nonsense."
I was heavily treated. I spit the pills down the toilet.
This is not possible in every department. Usually, when you take medicine, they will look into your mouth and pick you with a stick under your tongue so that you do not think of spitting out the medicine.
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What is a 7B diagnosis?
What is a 7B diagnosis?
- Some type of psychopathy (there are various forms)
(exists in various forms from depressive, suicidal,
polymorphic, mosaic to psychopathy of an excitable circle).
7B is a mild stage of schizophrenia, insanity, earlier under this article they were released from the army.
How did I get psychiatric help?
My interest in psychology, psychiatry, and the human sciences in general began from a hospital bed at the Kashchenko Clinic. I got there because of my unwillingness to serve in the ranks of the Soviet army. At first, he hid, did not answer calls, evaded subpoenas. However, a criminal case was initiated against me on the fact of draft evasion, and the subpoenas from the military commissariat were replaced by subpoenas from the police department. It was impossible to wait any longer. It remained only to surrender to a psycho-neurological dispensary, get a referral to a "psychiatric hospital" and "mow down" from the army, earning a diagnosis for himself, as representatives of the eighties bohemians did. In general, then we lived a lot of fun - we did what we wanted: some music, some literature, some painting, constantly gathering parties in the kitchen, discussing something. And in order to somehow exist, they got jobs as janitors, watchmen, stokers in boiler rooms, etc. For example, for some time I was engaged in industrial mountaineering, painting radio towers, high-rise buildings. The risk factor for life was taken into account when paying for labor, and in three months you could earn enough to live a whole year later, without denying yourself anything, doing only what you love.
In order not to follow the call, it was enough, as we said then, "seven". 7 B - code for a disease called "psychopathy". If we take a reference book on psychiatry edited by academician Snezhnevsky, we will read the following: "Psychopathy is a violation of adaptation due to pronounced pathological personality traits, their totality and low reversibility." classic definition. How is this condition different from psychosis, such as schizophrenia or TIR? The fact that it does not have a progression - the course, the development of the disease, the dynamics. Someone was born and raised with a number of maladaptive traits. They practically do not change during life. There is no deterioration in the picture of the disease, but a healthy person is not considered. I studied all this lofty theory in a week and a half, surrounded by special literature, and went to the people in white coats already fully armed.
There were almost no cases of someone leaving the hospital without a diagnosis at that time - as, indeed, now. At first glance, this is strange. After all, say, a dentist or a surgeon is more or less accurate in diagnoses. I thought it was the same here, and I feared the worst: I would be considered a malingerer, which, in fact, I was. Experienced doctors with great experience, I reasoned, should get to the bottom of the sly one. But it turned out just the opposite. I easily achieved my goal, although for this I had to endure many unpleasant hours in the hospital ward. However, communication with the doctors went surprisingly smoothly, and I easily received the diagnosis I claimed. At that moment, it turned out to be a mystery for me, which I solved later.
The whole focus is as follows. In psychiatry, unlike many other branches of medicine, the concept of "norm" is simply not disclosed. Its content is empty. If a person gets into the ward and communicates with the doctor, if they speak about him in the language of psychiatry, his condition will be described in terms of pathology, not the norm. Psychiatry can only speak the language of illness, the language of suffering. This is not easy to grasp, but that is how it is. Subsequently, having received a psychological education, I understood this very well. The well-known psychologist F. Zimbardo described cases when certified psychologists, traveling around the states, went to psychiatric hospitals for the sake of experiment, complained about their health and received any diagnoses, skillfully imitating the corresponding diseases - from neurotic disorders to reactive states and psychoses. After all, the only source of information in the diagnosis of a mental disorder is what a person says about himself and how he behaves. Well, also an anamnesis - that part of the medical history, which is compiled from the words of the patient himself and his relatives. It is clear that with sufficient competence, all this can be easily falsified.
But then, in the late 80s, it didn’t occur to me. Therefore, I was very worried and that I had the strength to study Soviet psychiatric literature in order to build a picture of the disease close to the features of my personality and biography, to play my syndrome as convincingly as possible. It was impossible to lose: since I was being prosecuted as an "evader", I had no chance of getting into a good place in the army. However, all this knowledge was useful to me later, when I set out to understand how psychiatric practice works, what are its cultural and anthropological foundations, implicit premises and assumptions, and myths.
Having previously arrived at the PND, I had a very miserable appearance, and I was immediately given a referral to the Kashchenko hospital. The psychiatrist, signing the direction, for some reason was nervous and even tore the paper with the tip of the pen. Only later did I learn that the degree of professional traumatization among psychiatrists is very high.
Once in the hospital, I ended up in the so-called "acute" department, in which most of the patients underwent forensic examination. Orders were very peculiar: something between an army and a prison, but a little softer. There were rapists and serious recidivist criminals lying there, and a few more people arrived from the army - they killed someone there during the service. Not surprisingly, the department was arranged in the manner of a prison. All personal belongings were taken away from us, giving out some terrible blue robes in return. All the windows, of course, had bars. Nothing like hospital wards in the usual sense of a normal person. These premises (about twenty beds) looked more like barracks. It was difficult to find adequate interlocutors - mostly semi-literate people lay on the tattered beds. However, I drank chifir with them, and they showed me a device for handicraft tattooing made from a guitar string. Sometimes we bribed nannies, and they ran to us for beer.
Books were given out there for an hour or two during the day - it was a special "reading hour". I took "Moscow - Petushki" with me to Venedikt Erofeev's hospital, but when all personal belongings were listed, the book was recorded as "Moscow and Petushki". This was written by the deputy head physician of the department, at first glance, a completely educated person. Then a certain Arkady Lvovich, an elderly man, an acute psychotic, asked me for this book. He constantly sweated and wiped sweat from his body with this book, so that it soon became unpleasant to read it, and some pages were simply impossible. After this incident, I never returned to reading Venedikt Erofeev. Recalling his famous novel, I always imagine Arkady Lvovich's unpleasant-looking body.
We were driven out into the corridor in the morning, and it was already impossible to enter the ward until the lights out. I had to pointlessly and monotonously walk along the corridor from wall to wall and smoke cigarette after cigarette. There were wooden boxes on the floor where patients threw their cigarette butts. The psychos mostly used Belomor and constantly forgot to put out cigarettes, and therefore there was a terrible stench in the whole department. I thought the hospital was a world of people in white coats. In Kashchenko, everything turned out to be exactly the opposite: this is one of the dirtiest places in Moscow. I have never seen more dirt.
TV was rarely allowed to watch, and there was a reason for this. For example, after watching a football match, someone would certainly start playing football with their shoe and drive it around the department, kicking it anywhere. Some, having stripped naked, made a ball out of their clothes, tightly folding it into a ball. Then, a couple of years later, when my younger friends were "mowing down" the army, the putsch was shown on TV, and the patients split into parties of the Gekachepists and Yeltsinists, set up barricades and threw potato peels.
After the command "Hang out" the light did not turn off: a huge lamp was burning in the ward above the door, by the light of which one could even read. Why this was done, I did not yet understand.
It is better not to talk about how they fed at all. Here it is appropriate to recall a few lines from Brodsky's poem "Gorbunov and Gorchakov". Joseph himself once experienced all this and wrote with deep knowledge of the matter.
"So in February we, mouths open,
stared out the window at the starry Pisces,
shifting bald nape,
in the place where the phlegm is on the floor.
Where fish is sometimes served at the table,
but they don't give a knife and fork to the fish."
Indeed, they did not give a knife and a fork: each patient was suspected of suicidal tendencies or self-mutilation. Default. Some, wanting to get out of Kashchenko, broke off a stalk from a spoon and swallowed it. This was followed by 2 or 3 months of "high". Until they put me in a hospital, until they do the operation, then the stomach will heal. Meanwhile, in an ordinary hospital, conditions are better, and in general life is more fun.
From the cigarettes brought to the sick by their relatives, the staff tore off the filters. The reason turned out to be very simple: the fact is that if the filter is set on fire and melted, and then rubbed over the tile with a heel and allowed to cool, a sharp plate is obtained, quite suitable for opening one's veins. Naturally, there was no question of any razors and watches in the department. Although the clock there, in general, was not needed - time dragged on for a surprisingly long time. In one day, you could live your life and grow old completely.
What was the treatment? They gave neuroleptics - drugs that affect the process of transmission of nerve impulses. This usually leads to a general decrease in mental activity. Productive symptoms like hallucinations, delusions and aggression disappear, but at the same time all emotions are extinguished, as if it were not a person, but a Dalai Lama doing meditation. This is reminiscent of a fairy tale about a peasant who asked a bear while he was sleeping to drive flies from his face. The bear took a large stone and drove the fly away. But at the same time he crushed the man's head. Soviet psychiatrists acted in the same spirit. Getting rid of the symptoms, they in a figurative, and sometimes literally, could simply crush the head.
They didn't give me pills. To conduct an examination and diagnosis, the patient must be "clean", must be himself. Once I had a severe headache, but it turned out to be impossible to interrogate analgin from the doctors.
In an ordinary clinic, the doctor asks: "What are you complaining about?" Here the question was different: "Why do you think you are here?" And again: "Do you think you are really sick, or do you think you are healthy?" Not a bad start for a conversation between doctor and patient, right? My answer was ambiguous-florid. Something like: "I have difficulty communicating with people because of their primitiveness and too simple interests." Immediately, of course, they began to ask about my own interests and lifestyle. Including favorite books. I named Borges, Nabokov, Boris Vian, Joyce, Cortazar, Kobo Abe, Camus. Most of these names did not say anything to the doctor, and on the basis of the "reading circle" no conclusion was made about me. They asked about poetry. I named Joseph Brodsky. The doctor happily nodded his head: "Yes, yes, Brodsky was also in a psychiatric clinic. I even saw his medical history."
I mentioned Japanese poetry - he asked for something to read as a keepsake. I recited to him several haiku of Basho and Issa. The last question was: "What is your goal in life, what do you want?" Adhering to the course of floridity and reasoning, I answered this way: "Any goal set is a limitation of one's capabilities." In the spirit of Zen Buddhism. And the doctor wrote down behind me: "The goal of the patient is to consistently limit all his possibilities." What I told my parents. With such a goal, of course, you can’t think of a better solution than going to the hospital. In addition, the doctor referred to "verses of Japanese poets" and said that I attribute someone else's authorship to my own texts, and concluded that I simply hear voices reading these poems: "Voices of unknown Japanese poets. All this without rhyme, without size. In general, it is clear that the young man wrote himself. "
I say one thing, but an experienced doctor, a recognized specialist, a seemingly educated person, hears and understands something completely different. In everything I say, he a priori sees only the symptoms of the disease, nothing more. It feels like two absolutely incommensurable pictures of the world have collided. Two different languages, between which there is an abyss, and translation from one to another is completely impossible. What exactly generates this abyss, what mechanisms are its condition? This question at that time represented an unsolvable riddle for me.
How I Became a Psychologist
And therefore, having returned to ordinary life and enrolling in the Faculty of Psychology of Moscow State University, I continued to study the history of psychiatry, trying to trace how its fundamental concepts were formed, what concept of a person underlies it. I tried to answer the question: how does a modern psychiatrist think and what determined exactly this and not another way of thinking? For a psychiatrist, when looking at a patient, something becomes obvious. And what cultural processes underlie this "evidence" and shape it? Questions like these lie outside of psychiatry itself; we find ourselves, rather, in the realm of cultural history and the social sciences. In order to comprehend psychiatry as a cultural phenomenon, the means of psychiatry itself are not enough, and going beyond its boundaries for a physician is, in principle, impossible. Medicine does not pose such problems.
Some acquaintances, having reached military age, began to turn to me for advice. I supplied them with the necessary literature and gradually expanded my knowledge myself. We sat with each of them and, under my guidance, "studyed the issue." At first, we wrote an anamnesis together - the history of their life and illness. Then I worked with their parents, and we made a plan: what and how to talk with doctors. Then they paid a visit to the doctor. As a result, all the guys, without exception, were given referrals to psychiatric hospitals, where they received the diagnosis we planned. There were no failures, and my convinced pacifism helped dozens of young guys to be released from military service.
How to mow? Everyone makes the same mistake. The fact is that all symptoms in psychiatry are divided into "productive" and "negative". Mental illness adds something and takes something away from the patient. "Productive" symptoms are those that a sick person has, but a healthy person does not. For example, delirium, hallucinations, catatonic stupor, hysterical arc. And for some reason, the majority tried to play precisely the "productive" symptoms, and this is extremely difficult to do, it will look "unnatural", and the doctors, most likely, will figure out the trickster. But there are also "negative" symptoms. This is what a healthy person has, but a sick person does not. For example, sociability, cheerfulness, attraction to the opposite sex, good appetite and sleep. When a person mows down under the "negative", it becomes immeasurably more difficult to figure it out.
By the way, the problem of "neutralizing" unpopular diagnoses was easily solved. It was enough to come to the PND, take a card at the reception, saying that you were going to the doctor, and then this card. burn. And that's it, you are no longer registered, but the information remained in the military registration and enlistment office.
I then read the classic "Clinic of Psychopathies" by Gannushkin, "History of Psychiatry" by Kannabich, "Handbook of Psychiatry" edited by Snezhnevsky, works by Kandinsky, Korsakov, Gilyarovsky. Then he began to study the works of Western psychiatrists. I was immediately struck by the lack of unity in the views of various medical theorists, the presence of many opposing schools in psychiatry. The deeper he delved into the problem, the better he understood that book descriptions have little in common with the real life of psychiatric departments, where no treatment actually takes place.
Gradually, I realized that it was the experience that I gained in the hospital room that was truly indispensable. By checking it with medical theory, I learned much more about the mechanisms of the so-called treatment than a simple psychiatrist who got a job after medical school.
Foucault: church, prison, clinic
One of the most powerful research experiences was associated with reading the books "The Birth of the Clinic" and "The History of Madness in the Classical Age" by Michel Foucault. The latter is by no means a psychiatrist, but his reflections turned out to be extremely valuable.
In his writings, it was possible to find answers to some painful questions that matured in me during my stay in the clinic.
Foucault begins his reasoning with this fact. Until the end of the 18th century, the concept of "mentally ill" simply did not exist in Europe. There were special institutions - workhouses, where deviants were kept: vagrants, petty thieves, beggars, pickpockets. And even alchemists. It was a group of people who are unable or unwilling to adapt to the social regime - and thus interfere with its normal functioning. The place they were placed in was a typical penitentiary.
But no one called these people sick. Rather, they were just outcasts, sometimes criminals or "eccentrics". That is, in fact, the very rabble that I observed in the Kashchenko hospital. Nothing has changed in a couple of hundred years. True, no diagnoses were made then, because psychiatry was just in its infancy. Thus, Foucault's idea is not at all that until the end of the 18th century there was no concept of "insane", but that there were patients themselves. By no means! He claims something much more interesting: up to this point there was no patient himself. Foucault demonstrates that psychiatry has not only re-examined mental illness, but that it has created them. She makes a sick person out of a person. I came to roughly the same conclusions.
Here's how it happens. Persons who were previously described in the language of penitentiary systems as transgressors of the law are now described in the language of medicine. One can consider this as some liberalization of punitive systems and institutions. In fact, the practices that are applied to the patient are structurally identical to those that were previously applied to the criminal.
In one case - an interrogation, in the other - a doctor's appointment (a frank confession is a condition for both healing and overcoming vicious desires). The offender must speak frankly about what he did, the patient - about painful experiences. In one case, a punishment is prescribed, in the other, a method of treatment. But they are usually the same. Hierarchical supervision dominates here and there - both the sick and the guilty are constantly "open for inspection" - the authorities make their object "show themselves." Surveillance techniques are equally inherent in a prison, a military hospital, a psychiatric hospital. An even more ancient model, a prototype of the correctional system, is the church. There a person comes to the confessor and repents of sins. Sins are forgiven, or penance, obedience is imposed. The court pronounces a verdict and awards a term of imprisonment with corrective labor. And the doctor diagnoses and prescribes treatment, hospital regimen, painful procedures and manipulations. Church, prison, clinic. At the disciplinary level, each subsequent system is a copy of the previous one, this is quite obvious.
If you look at what some of the treatments in the psychiatric hospital looked like, it becomes clear that this is a real punishment.
In acute departments, especially during forensic examination, the patient could be tightly tied to the bed. It is worse when the exacerbation is "stopped" by an intramuscular injection of sulfur - after such an injection, the patient experiences terrible pain with minimal movement. Another torture that Torquemada himself would not disdain to replenish his arsenal with is “trick”, binding tightly with wet sheets. Drying, the sheets squeeze the patient even more.
Foucault abandons the historical approach in favor of the genealogical one. If, for example, the history of morality is investigated, then the existence of some "original morality" is assumed, with which this history occurs. Or a story of madness. The historian will assume the existence of a "primordial" madness, and then he will write its history - he will demonstrate how the status of the madman changed over time, how psychiatry was born, etc. The very same madness with this approach will look like something unchanged.
Foucault, in defending the genealogical approach, does not presuppose the existence of that primordial something with which history happens. Genealogy understands the subject under study as the effect of social forces, the product of power, if you like, a historical product. And if the concept of "mentally ill" appeared only in the 19th century, there is no reason to assert that the sick themselves existed earlier. The concept of "mental illness" is a historical phenomenon produced by the configurations of power at a certain time, and we have no reason to attribute historical immutability to it. A mentally ill person is not a person with an illness at all. This is a person about whom it is considered necessary to speak in the language of medicine. Before, he was just a deviant. He became sick when the doctors started talking about him.
I've seen a lot of forensic cases and this is the conclusion I came to. If a certain person is examined by a forensic specialist, he will discover the corpus delicti and, naturally, will see guilt. If a psychiatrist examines him, he will most likely find symptoms of the disease. The priest, of course, will see a sinner in front of him. It is impossible to establish how things really are - whether a person is guilty or sick.
Because this is a problem of choosing a language, a coordinate system. Speaking in a philistine style, it all depends on which bell tower to look from. Here is the question: can a person with aggressive impulses be considered healthy? Like when. There is just violence, but there is violence according to the rules, for example, the laws of warfare or dueling. Whether this is a norm or a pathology, it is decided on the basis of an agreement. Could the accused extinguish his aggressive impulses with his will? It's like the doctor says. The very question of the existence of will and free choice in modern psychology remains open. Thus, medical, criminal and religious conventions are just different ways to control the mass of deviants, that's all.
Under the influence of the same considerations, Foucault described in detail how workhouses, military hospitals, and later psychiatric institutions are arranged. They were the idea of "Panopticon" by Jeremy Bentham. What is "Panopticon"? An architectural structure built according to the following principle: in the center there is a tower where the guards sit, and on the periphery there are buildings that form a ring. They have prisoners. The idea of the Panopticon is to see the controlled body without being visible. So that's why the lights were always on in the wards of Kashchenko's acute department and any nurse, walking along the corridor, could see what was happening in the wards! The main result of the Panopticon is to produce in the people placed in it a feeling of their constant supervision, an awareness of the fact that they are constantly visible, and this is precisely what ensures the automatic functioning of power. The effect does not depend on whether you are actually being observed. After all, man is a social animal. That is, a creature that picks its nose when it thinks that no one sees it.
Psychiatry as a disease
So, if psychiatric treatment is a repressive practice, then what is illness? Rather, the status, rather than the real condition of the patient. For example, what is schizophrenia? Brain research reveals little. It is not possible to give an exhaustive description of schizophrenia in the language of neurophysiology. And besides, is it one syndrome or several different ones? Dont clear. Then on what basis do we assert something about illness? But you can approach the issue differently. I argue that the content of the concept of "schizophrenia" is reduced to a combination of diagnostic methods and methods of treatment. There is nothing else behind this concept. Such logic goes back to the operationalism of P. Bridgman (a prominent scientist, Nobel laureate in physics), who in 1927 proposed a curious idea of overcoming the crisis in physics. According to Bridgman, the actual content of physical concepts is reduced to a set of experimental operations, more precisely, to a set of measurement operations. For example, what is length? The concept of length is meaningful if the operations by which the length is measured are fixed. The concept of length, strictly speaking, does not contain absolutely anything other than the totality of operations by which the length is determined. Or - the concept of "time". The clock is not a device that determines time, but, on the contrary, time itself is what is measured with the help of a clock.
This operationalist approach has begun to infiltrate psychiatry in the last twenty or thirty years, but even it does not eliminate the difficulties, since there is no unequivocal diagnosis of fundamental disorders in medicine. Moreover, doctors belonging to different schools will make different diagnoses. Someone has a broader concept of "schizophrenia", someone has a narrower one. It is not surprising that the psychiatrist Bleuler, who first used the term "schizophrenia", spoke of "feeling schizophrenic" as a diagnostic criterion. That is: "the patient smelled of schizophrenia." It's an intuitive diagnosis. Doctors, reserving the right to have a "feeling of schizophrenia", simply sign their own helplessness.
By the end of the century, due to the rapid development of natural science, medicine operated mainly on the "alloplastic picture of the disease." Picture from the perspective of the external view. The patient himself does not know what is happening to him. You can not rely on his testimony .. It is necessary to use devices, ultrasound, thermometer, pictures and so on.
But with mental illness, insurmountable difficulties arose. There is something that only the patient can feel and see. We cannot survive other people's hallucinations, fears, suffering - it is impossible to see them from the outside. The very essence of the disease lies in the fact that the patient thinks and feels. Illness is his inner world. The disease through the eyes of the patient himself, that is, an autoplastic picture. How can you understand it from the outside? The leading physicians of the turn of the century were convinced that if it was not possible to find external manifestations of the disease accessible to objective observation, then the patient was pretending. For example, functional disorders, paralysis in hysteria. There are no objective violations, and the limb is paralyzed. Freud was laughed at for his studies of hysteria, until at one examination he stuck a pin in the leg of the "old woman-pretender". And she felt no pain. Thus, Z. Freud was able to demonstrate to his colleagues that the limb was indeed paralyzed, since there was local anesthesia accompanying real paralysis. But the hypnosis of natural science and hopes for an objective psychology was very strong, which eventually led to a crisis in psychiatry.
Psychoanalysis gave some chances. But, alas, Freud, although he was translated into Russian earlier than into other European languages, was banned in the 1930s. In 1936, the famous decree "On Pedological Perversions in the System of the People's Commissariat of Education" was issued, and psychoanalysis, which Trotsky actively supported in the 1920s, was forgotten for a long time. Following Pavlov and Bekhterev with his book "Objective Psychology", the approach based on the alloplastic picture of the disease began to dominate in our country. At the same time, the famous Institute of the Brain was founded, the first task of which was to study the brain of Lenin. This is understandable. Based on the alloplastic perspective, it was believed that the brain of the leader of the proletariat must be somewhat different from the brain of an ordinary person. But no significant differences could be found.
But it was a drawn-out retreat. As for me, I acquired the skills of real psychological help precisely because of everything that happened to me.
For example, I was one of the first in Russia to undergo holotropic breathing with the students of S. Grof. They argued that there is not only personal (ontogenetic) memory, but also phylogenetic - the memory of the species. Moreover, this information can be pulled out of the unconscious. I did a couple of sessions with them and got some experience.
It so happened that after 1991, Western psychotherapists began to come to Russia. And we got the opportunity to travel to the West. I attended master classes of prominent Western psychologists: J. Rainwater, M. Ruffler, S. Grof, and others. I mastered the techniques of Gestalt therapy, psychosynthesis, psychodrama, holotropic breathing, group psychotherapy, and psychodiagnostics.
A number of firms providing psychological assistance were created. For example, Crocus International is a Russian-American organization that consulted on AIDS issues. I was engaged there in psychological counseling of risk groups and at the same time studied at the psychology faculty of Moscow State University. Subsequently, I was sent to St. Petersburg for a one-year course in psychological counseling at the Harmony Medical Center. Then, in 1991, I made a presentation at the world's first international conference dedicated to working with risk groups.
It is interesting that all my subsequent scientific activity was in one way or another connected with psychological problems, with the problems of nosology and the history of medicine. Take, for example, the author's courses, which I taught for several years at Moscow State University - "Psychoanalysis as a Social Theory", "Cognitive Strategies in Modern Social Philosophy".
In 2000, I received a pleasant surprise. The All-Russian Independent Psychiatric Association organized seminars for thinking psychiatrists. The best psychiatrists came from different cities of Russia. I was invited to lecture. I called my course "The Anthropological Foundations of Psychiatry." I devoted the first lecture to the psychophysical problem. It is difficult to convey my feelings when I began to lecture to psychiatrists, whose qualifications far exceeded the professional level of my tormentors who diagnosed me.
But one day a serious threat loomed over me again. I was not guilty of anything, but I was persecuted by law enforcement agencies. Then, in the 1990s, Yeltsin's famous decree "30 days" existed - a person could be kept in custody for a whole month without being charged. And get the right evidence. Article 7B (psychopathy), which I had, exempted from the army, but not from criminal liability. I had to go back to the hospital to get a more serious diagnosis - schizophrenia. And unfavorably flowing. This scenario is immeasurably more difficult to play. But it was worth it. After all, if a person has left a psychiatric hospital and he has a referral to VTEK, then the law cannot do anything with him. Moreover, with the goodwill of the doctor, even the interrogation of the patient is impossible. And this is another evidence that psychiatry is just an alternative to the penitentiary system. If you apply to this system yourself, then you are protected from police attacks. And I turned to the famous 15th hospital on Kashirka, where I lay for several months. I even traveled from there to take exams at Moscow State University and successfully passed them. According to the symptoms that I presented to the doctors, I had a high probability of exacerbation. I was heavily treated. I spit the pills down the toilet, but at the same time I talked with friends from the Serbsky clinic, who told me how these pills should work, and I imitated their action. The result was a good diagnosis. It was approved for me by a professor from the Serbsky Institute with a work experience of forty years. He was considered the "luminary" of psychiatry. "Svetilo" gave me the necessary diagnosis without any hesitation. When the representatives of the law discovered that not only did I have malignant schizophrenia in my medical history, but also a referral for disability, they quickly fell behind me. The piquancy of the situation was also in the fact that, having received the necessary diagnosis, I immediately got a job as a psychologist in one of the famous Moscow lyceums. All this happened in 1997. Subsequently, I calmly graduated from the university, graduated from graduate school, and then began to teach at the Faculty of Philosophy of Moscow State University. I'm currently writing a book about MPD - multiple personality disorder.
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