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CLINICAL FORMS, COURSE AND TREATMENT METHODS OF
MANIACAL
-
DEPRESSIVE PSYCHOSIS DISEASE
1
Akramov Sirojiddin Ilyos o‘g‘li
2
Buronov Javoxir Otabek o‘g‘li
3
Turayev Bobir Temirpulotovich
1-2
Student of group 532 of the medical faculty of Samarkand State Medical University,
Samarkand, Republic of Uzbekistan
3
Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State
Medical University, Samarkand, Republic of Uzbekistan
https://doi.org/10.5281/zenodo.14631213
Abstract.
The study focuses on the topic of clinical forms of maniacal – depressive
psychosis and their psychopharmacotherapy, provides information on the etiology, pathogenesis,
clinic of this disease, theoretical knowledge about mental disorders, comparative diagnosis of
disease variants from other diseases, issues of measures for modern diagnosis and treatment of
the disease, and on rehabilitation problems.
Key words:
Maniacal-depressive psychosis, psychopharmacotherapy, etiology,
pathogenesis, diagnosis, treatment, rehabilitation.
КЛИНИЧЕСКИЕ ФОРМЫ, ТЕЧЕНИЕ И МЕТОДЫ ЛЕЧЕНИЯ
МАНИАКАЛЬНО
-
ДЕПРЕССИВНОГО ПСИХОЗА
Аннотация.
Исследование посвящено теме клинических форм маниакально–
депрессивного психоза и их психофармакотерапии, содержит информацию об этиологии,
патогенезе, клинике этого заболевания, теоретические знания о психических
расстройствах, сравнительной диагностике вариантов заболевания с другими
заболеваниями, вопросам мер современной диагностики и лечения заболевания, а также о
проблемы реабилитации.
Ключевые слова:
Маниакально-депрессивный психоз, психофармакотерапия,
этиология, патогенез, диагностика, лечение, реабилитация.
Introduction.
Maniacal-depressive psychosis (cyclophrenia, circular psychosis,
cyclothymia) is a periodic mental illness with depressive and maniacal stages and a period of Tula
wellness between them – alternation with intermission. Maniacal-depressive psychosis includes
freely expressed types (cyclophrenia) as well as soft expressed types (cyclothymia) [1-3].
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The current manifestation of maniacal-depressive psychosis is the German spiritualist
scientist E.Crepelin is described. In the period leading up to it, the concept of an independent
disease, such as separate mania and melancholy, could prevail in the opinion of Hippocrates
(Bucrotus) [4-6].
To highlight maniacal – depressive psychosis as a separate nosological unit, E.Crepelin
carefully compared each other with cases where clinical manifestations are opposite (internal unity
of depressive and maniacal disorders), their origin and characteristics (hereditary – generality,
similarity of family background), course (periodic – stage) and ultimately — result (non –
formation of personality – final defect) [7-10].
Etiology and pathogenesis.
From the time of crepelin, maniacal-depressive psychosis is
introduced into endogenous diseases. These include biochemical and other biological changes in
the patient's div (changes in catecholamine metabolism, disruption of mineral Metabolism,
effects of endocrine changes, etc.), hereditary aspects, age and gender in the div [11-14].
Kallman reports that the risk of contracting two zygotic twins is 20-25% compared to 66-
96% in monozygotic twins. Again, in families whose parents are diagnosed with maniacal –
depressive psychosis, the proportions of feeding on their children are also being determined. It is
necessary that the appearance of maniacal – depressive psychosis, sex, structure of the torso, the
relationship of the individual with the state before the disease – women are more likely to get sick
than men. 60-70% of maniacal – depressive psychosis patients are women. The meaning of the
catecholamine hypothesis is that in the case of depression, there is a functional deficiency of
norepinephrine in the brain, and activation in the brain. A dexamethasone test is used to study
violations of the functioning of the adrenal gland [15-19].
Clinical picture
and course of maniacal – depressive psychosis: maniacal – depressive
psychosis can begin at any age – from children to the elderly. In contrast to epidemiological data,
the disease often begins at mature and advanced age (40-50 years old). With maniacal – depressive
psychosis, women are more likely to be ill (up to 2 times) than men, with a higher proportion of
women confirming the incidence by all authors. E.According to the data of crepelin and his
contemporaries, maniacal – depressive psychosis is a common disease, and this mental diagnosis
is poured and treated in 10-15% of diseases [20-26].
The main and Uzi – specific manifestations of maniacal – depressive psychosis consist of
depressive and manacal stages of depression and uplifting mood. The main leading clinical
manifestations of maniacal – depressive psychosis are depressive (maniacal) and maniacal (manic)
syndromes (stages) [27-30].
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Although the stages of manifestations of maniacal – depressive psychosis disease differ,
they have many common sides. The totality is such that disorders are observed in the same and
same part of mental activity, which can be grouped into three large groups.
1. Mood disorders.
2. Violation of the speed of thinking.
3. Speech-the acquisition of movement activity.
Depressive stage.
The depressive phase is characterized by three signs:
1. Tunkunlik-with a sad mood.
2. With a slowdown in thinking.
3. With slow motion.
In the initial period of depression, it begins to feel unpleasant, there is a sad background in
all experiences, interest in life weakens, asthenic disorder is observed, kuli does not go to work.
Night - it is against the background of the mood of the day that sleep is disturbed, appetite
decreases, work capacity and productivity decrease. Lange blurs, relaxes, gets up in the morning
with difficulty. The mood of patients is stable, joy and cheerfulness retreat, the environment looks
dark for autumn, and interest in it subsides. Later, as the disease worsens, depression increases,
the expression acquires a specific appearance, the disease is thrown into a clear autumn, which
becomes known in the behavior of the patient. Although it is momentary for the patient, the
feelings of joy are alien (for example, even if his daughter enters the Institute), constantly feel
physical pain in his heart, often feeling his heart shrinking, “heart sadness” [31-36]. Depression
the patient feels in the form of an external one, sadness remains on his face as if a secretary, his
movements are very sluggish, his eyes are rough, he has no moisture, he does not blink. The torso
is bent, the arms are hung next to it, they themselves are relaxed, they do not have affairs with
those around them, they lie or Sit without moving. Patients feel as if berk is stuck in the street, and
believe that he can only be expected to kill himself in one way or another, so patients are at risk
with suicidal movements in the event of depression [37-42].
Further deepening of the Depression was first observed by UTA assessed, ultimately self
– incrimination with broken temptations, sinfulness, self-deprecation, Ippo-chondric cases,
encouraging other patients to kill Ham uz-himself.
One of the signs characteristic of patients in the depression phase is severe experiencing
insensitivity – anesthetic depression. Patients complain that we do not know the joy in this, I have
become indifferent at night. They say to loved ones, to their children, I lost sincerity, humanity
and became like a heartless robot [43-46].
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Most often, depression is accompanied by anxiety ( anxious depression ) panic, unrest,
patients growl, cry, crackle their days, do not find a place for self – burns, often these situations
reach a state of melancholy and periodically try to self – injure and kill. Patients become camphor,
answering questions slowly, with camphor, pausing and after repeated pleas.
Maniacal stage.
The main clinical manifestations of the maniacal phase are represented
by a triad of symptoms:
1. With a bruise of mood;
2. With the speed of thought;
3. By the fact that the movement is lamb.
They can be expressed to varying degrees. Accordingly, the maniacal phase is divided into
light – hypomanic, expressive and heavy (temptation of glory ) manias.
The sick will be in a good mood, laugh hard, sweat on the way, feel happy themselves.
They always consider themselves mature, remain captivated – they believe that they are
talented and know a few foreign languages, they begin to see taorgism trying to enter three
institutions at once, they consider uzs a popular artist, singer, poet, they seem to be able to
overcome great scientific or political problems. Having begun to correctly answer the doctor's
questions, the patient immediately becomes distracted from savlo and becomes intrigued by the
newly formed dust of thoughts in his brain. Patients are unable to control themselves, speak with
a muffled sound without stopping, sing, read poetry, do well to say words in pairs, explain the
events surrounding them with a high spirit, interfere with every job in the department, give advice
[47-50].
The decoration of the behavior of manic patients is due to increased hyperreactivity and
interest, sexual sensations. Patients have a high appetite, but they lose their face, often burn out in
gross sexual acts, talk a lot in erotic content. After leaving the maniacal state, they feel an asthenic
state.
Atypical forms of mania also differ (depending on the behavior of patients, the intensity of
psychopathic symptoms).
1.Cheerful manias are accompanied by euphoria, self – assessment and feel good.
2.Expansive manias, the addition of valuable ideas with the acceleration of mental
processes to the first place, manifested a desire for activity. Other signs of mania are mildly
expressed.
3.Angry manias – with their anger rolling out, fall into aggressive actions, these-into the
dirt from the nail.
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Treatment and Prevention.
With the onset of maniacal – depressive psychosis, patients
are admitted to the stationary as they notugri the Uzi in manic cases, and in depression they are
given suicidal actions, remaining in love with the treatment. It is necessary to keep them in check
so that they do not bully them, creating half-seated conditions for patients in a state of depression.
A self-attempt is often made in the morning, because at this time the patients are sleeping
smudges, the sensitivity of the medical staff is reduced smudges.
Treatment treatments:
are related to the clinical picture of the disease (linkages to
depressive or manic condition) as well as their expression and clinical isolation (typical stage,
anxious depression, seduction depression, atypical stage, stretched stage, etc.), it is necessary to
take into account the age of the patient and other factors [51, 52].
It is constantly monitored physical condition, taking into account the individual
characteristics of the patient. In manic cases, neuroleptic sedatives are prescribed, neuroleptics
with sedative effects (chlorpyrotexin, aminazine, tizexin or galoperiol) are given to relax the manic
pupil.
The average daily intake of galoperidol is 30-60 mg, while chlorpyrotexin's 150-300 mg of
aminazine is 300-600 mg, and tizersin is 150-300 mg. Treatment lasts 2 – 3 months, the amount
of neuroleptic is gradually increased, the healing effect is manifested by Salts of lithium, which
can be added with neuroleptics. Lithium salts do not have an antidepressant effect, but they weaken
the symptoms of manic excitability. The condition of patients usually improves in the first week.
The dosage of the appointment depends on the micdor of lithium in the mine (1-1.5 days).
Carbamazepine, finlepsin, tegretsol, which are used in the next vaccine in the treatment of
mania and depression, are giving good breath. The daily amount is 600 – 1000 mg, and is a link to
the amount of carbamezipim in the mine (6-12 gr/l). the effect of treatment is known much more
often – in 5 days-Ham, both in the manic stage and in the depressive stage. Antidepressants-
thymoleidine have a mood-enhancing effect. In addition, they affect the state of anxiety and
braking. If the leading sign is life sadness, oppression (to be with the classic depressive Trinity),
it is necessary to appoint antidepressants that are timoleptic and mood-enhancing, seeking to show
the activity of the stimulating component of self-behavior. Lipipromine (ilenzine, imipramine),
Anafranil, pyrazidol, melipromil, 100 – 300 mg per day, Anafranil 100 – 200 mg per day, pyrazidol
200 – 400 mg per day, treatment for 10 days from onset, intravenous or intravenous drip method,
followed by drinking.
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