Patients with characteristic features of asthenic circle

The originality of the clinic and dynamics of alcoholism in patients with asthenic character traits already noted by several researchers (Sukhanov, 1906; Ivanets, Igonin, 1976; Mubarakova, 1977). Observed by us patients belonging to this group, already from childhood was marked by poor tolerance to the physical and mental stress, exhaustion, easy fatigability, which most of them were combined with increased sensitivity, sensitivity and a tendency to irritability. Flash irritability patients were very short, easily changed in remorse and guilt. They are characterized by high exactingness, often associated with low self-esteem. They were timid, shy, prone to introspection, self-analysis, often suffered from anxiety, a sense of hidden threats. For them, the typical lack of self-confidence, a sense of inferiority, uncertainty, excessive self-criticism, the tendency to abandon. They also knew emotional instability and vulnerability. Sick was not characterized by high activity, a small new things often seemed to them too troublesome, restless. They avoided the high stress, responsibility, it is not easy to mix with people, hardly adapted and long got used to the new surroundings.
Already from the first experiences of alcohol they quickly allocated those of its quality, which had for them some of the "usefulness". Meeting with alcohol is often considered timely discovery, successful case. The main importance had the subjective effects of intoxication: the release of tension, stiffness, euphoria, confidence, strength, facilitating communication, increasing the overall tone. These effects largely compensated for the particular mental warehouse of astenikiv, pointed in unfavorable situations. Quickly produced persistent individual motives of alcohol consumption associated with obtaining the intoxication subjectively significant effects.
The systematic use of alcohol often started in connection with the delayed adverse situations that require significant mental stress and exhausting patient. Sometimes patients deliberately drank with the goal of "prevention" of those or other possible adverse moments. In other cases, the systematic use of alcohol debuted in communication and in the background of disadvantaged micro-social environment, but in such cases, patients quickly allocated from drinking traditions, rituals and customs of the fact of reception of alcohol and the effects of intoxication.
Patients reported that from an early time in a special attitude to alcohol, highly appreciated its positive properties. At the same time, the negative consequences of excessive drinking and negative attitudes towards drinking also clearly were aware sick. They avoided thoughtless and idle pastime in alcoholic companies did not seek aimless drinking-bouts, and tried initially to regulate alcohol intake based on your own needs. They focused more on their own condition and well-being.
The patients indicated that the situation, which served as the reason for the use of alcohol, prevailed those that may cause undesirable experiences and status (communication, including intimate, anxious expectation, fatigue, trouble and so on). But the increased frequency of alcoholic excesses occurred in most cases, slowly, so slowly expanded the circle of motives, reasons for drinking. Over time they began to experience difficulty when trying to do in this or that unfavorable situation without the help of alcohol. In such cases, they would anxiety, mental tension, stiffness, feeling the discomfort, appeared and strengthened the idea about the desirability of taking alcohol.


Patients reported that without alcohol they rarely felt mental comfort, did not feel the feelings of serenity and peace, felt at ease", looked passive and indecisive.
The frequent appearance of the desire to use alcohol at times disturbing was sick. Positive social attitudes fed opposite trends, resisted the urge to drink alcohol, it was often achieved considerable intensity, accompanied by mental stress, anxiety, restlessness, excitation. So, for another I first stage of the disease the mind of the patient becoming the arena of struggle of opposing trends, struggle, delivering painful experiences are very patient. The inability of patients to quickly make a single decision also contributed sometimes painful struggle with their own desire to use alcohol. But, perhaps, only in patients asthenic circle dominated psihologicheskih damn struggle with the desire to drink at times at the second stage of alcoholism acquired the character, close to Intrusive state.
The patients themselves have linked the struggle of motives with worsening desire with the presence of any obstacles to drinking. Astenikov these were mainly internal barriers and prohibitions based on positive social attitudes of the individual.
Relatives of patients indicated that persistent emotional excitement, vzbudorazhena before taking alcohol occurred in patients until a considerable time after the beginning of the systematic use of alcohol. However, the patients themselves believed that by the time of formation of a hangover experiences associated with the use of alcohol, took an excessively large place in their mental life. But still they did compromising their alcohol companies, not engaged as partners feast of persons with obvious signs of alcoholism.
Updating the primary attraction is already at stage II was accompanied by mood swings, varying in intensity.
The desire to use alcohol approaching II stage (in 6-10 years after onset) occasionally appeared in the mind of the sick and out of touch with ordinary individual reasons, and in view of the uncertain mood, the impulse to binge.
However, the reduction of quantitative control began to disturb patients much later. Experiences associated with worsening desire to continue taking alcohol and drunk, were less bright and largely controlled patients. The pursuit hung over in the framework of the alcohol withdrawal syndrome also sometimes had no force of character, and the patients were in the state for a long time to wait hung over.
During stage II (in 6-10 years after onset of illness) updating the primary pathological attraction to alcohol was mainly under the influence of individual factors (weakness, fatigue, stress, negative emotions, anxious expectation, and so on).
Clinical symptomatology actualization pathological attraction to alcohol in patients with characteristic features of asthenic circle on the II stage of the disease was characterized by the dominance of psychopathological disorders.