Endocrine mental syndromes

Endocrine mental syndromes of mental disorders that occur when different endocrine diseases: Addison disease, a disease Itsenko - Kushinga, graves ' disease, myxedema, diabetes, lesions of the pituitary gland. Endocrine mental syndromes appear near symptoms, which is the consecutive stages of the same disease process. If within endocrine diseases occur mental disorders, first they are psychopathic disorders, may later develop acute or prolonged psychosis and, finally, there may be a persistent organic personality changes with reduced memory and intelligence.
Psychopathic disorders often occur in violations attractions - in raise, lower or the perversion of sexual desire, sudden change of appetite, the taste sensations, thirst; often there is a tendency to wander. Characterized by the reduction of mental activity, expressed in lethargy, fatigue, the patient needs to be driven from the outside in order to do anything. In this age often have shallow mood changes. Depression combined with tearfulness and irritability; hypomanic state are accompanied by carelessness and euphoria.
Acute psychosis usually occur with a change of consciousness in the form of delirium, oneiroid, stun or Amancio (see Consciousness disorders). In severe cases, amentia and stunned may be followed by coma. Protracted illness manifested primarily a variety of affective and hallucinatory-delusional States (see Affective syndromes, Delusional syndrome, Hallucinatory syndromes).
Organic personality changes occur gradually. Often they appear in primary and secondary periods of illness, i.e. accompany and psychopathic disorders and state of psychosis, as a kind of background, coloring productive (affective, delusional, and other) disorders. In these cases, organic changes usually expressed blurred, appearing more frequently to reduce the level of personality (see Dementia).
Expressed organic changes were likely have different levels of depth phenomena gimnazicheskoe dementia. Patients with initial forms of the disease and organic mental changes should be sent to the psychiatrist. Patients with psychosis, especially acute need urgent hospitalization in a psychiatric hospital, accompanied by a nurse or nurses.
It is necessary to treat the underlying physical illness, and to prescribe psychotropic drugs (see Psychotropic drugs).

Endocrine mental syndromes - a symptom of mental disorders that occur in diseases of the endocrine glands. Describes the following two basic syndrome: psychopathic (or endocrine psihosindrom) and amnestic-organic. On the background of one or another syndrome often in connection with the severity of endocrine diseases may develop acute psychotic States (syndromes amantino, delusional, paranoid, delusional paranoid and others) and a protracted illness. The development of the endocrine mental syndromes reflects patterns of development of the main disease.
Psychopathic syndrome, or endocrine psihosindrom, Bleiler (M Bleuler), developed in the earlier stages of the disease and in cases of a relatively benign its course. Typical reduction of mental activity, disorders of drives and instincts and mood disorders.
Each of these disorders, and especially the combination of them, has a number of features that differentiate psychopathic syndrome endocrine nature from a similar condition in other diseases.
The decrease in mental activity can be expressed in varying from fatigability and passivity to its full spontannosti with a significant reduction of the range of interests and simplification of contacts with the environment.
Disorders of drives and instincts are manifested in the reduction or enhancement of sexual feelings, appetite, thirst. There is an aspiration to wander or, on the contrary, be within the usual limited area. Change the need for sleep, heat, etc., the Endocrinopathy more typical quantitative than qualitative, violation of drives. So in these cases are rare perversion (for example, homosexuality and other). There may be a dissociation of drives with some increase and decrease in others.
Mood disorders are diverse and vary widely in the extent of its severity as downward and upward. The main feature of the affective disturbance in endocrine diseases is the prevalence of mixed States: depression with restlessness, mania with euphoria, manic and depressive States with malice and hatred, depressive-apathetic state, asthenic depression, etc. May experience anxiety and fear. For affective disorders in endocrine mental syndromes characterized the mood lability with fast and wanton transitions from one emotion to another. Typical for classic affective syndromes associated changes in thinking and motor areas (lethargy in depression and hyperactivity in the state of mania) for endocrine mental syndromes are not typical. On the contrary, often there are dissolvine disorders, such as elevated mood with complete inactivity and motor inhibition. Affective disorder and psychopathic syndrome can be a long, that arise or be strengthened occasionally, reminding epileptic seizures or atypical flowing periodic psychosis.
Psychopathology of endocrine psihosindrom is not related to a specific gland of internal secretion, and described violations can occur at different endocrine diseases, to accompany both Hyper-and hypofunction separate glands. The originality of mental shifts at separate diseases is determined mainly by the predominance of a group of disorders in the General syndrome. For pituitary cachexia of Simmonds, edisonova disease and some other diseases characterized by pronounced predominance of reduction of mental activity, with ray - lability of mood and brightness emotional expressions, etc.
Amnestic-organic syndrome developed with a long and especially heavy during endocrine diseases and often replaces endocrine psihosindrom. Amnestic-organic syndrome is more common, global mental functions, which concerns all aspects of personality, greatly reducing its individual features. For amnestic-organic syndrome is characterized by disorders of memory (amnesia, Gimnasio, violations of the type Korsakov psychosis and others)intellectual decline with the expressed impaired ability to reason and critical attitude to the state. Fall acquired knowledge, thinking slows down and becomes more shallow. In the affective sphere begin to dominate features emotional dullness and stupidity. In the most severe cases, develops organic dementia dominated amnestic disorder in adults and dementia in children.

Acute psychotic syndromes develop on the background of both of these syndromes and can occur at any stage of the disease. Often they are caused by changes in the course of the basic disease in the side of his weight and increase metabolic, vascular and other irregularities (edisonova crises, hypertensive crisis, in patients with the disease Itsenko - Kushinga, etc). Usually develop psychosis, proceeding by the mechanism of acute exogenous reaction with specific syndromes (delirium, amentia, twilight dizziness and others); it may be epileptiform arousal or epileptiform seizures. The dependence between the occurrence of acute illness and time of occurrence and the severity of physical complications is not absolute. Sometimes this kind of psychosis occur for no apparent reason. This is especially true of psychosis associated with the prevalence of mood disorders (depression, anxiety paranoid syndrome), and psychosis schizophrenia-like psychosis structure with paranoid and delusional paranoid syndromes.
These psychosis often become protracted or may arise again. In such cases, we are talking about an atypical or periodic psychosis which are difficult for differential diagnostic evaluation.
Differential diagnosis. The basis for distinguishing psychosis endocrine nature from diseases other causes (schizophrenia, manic-depressive psychosis, epilepsy and others) should be based on a study of the shift of psychopathological syndromes in the process of diseases and disorders of inherent psychopathic and amnestic-organic syndrome, which preceded the more massive psychotic disorders.
Treatment. The main principle of treatment of mental disorders in endocrine diseases - this is the treatment of the endocrine diseases and correction of detected mental shifts through the use of neuroleptics, antidepressants, etc.
When using the latter should take into account the need to moderate doses and gradual increase of doses of these drugs prevent perverse reaction to them (see Psychotropic drugs).
When little expressed violations preferably prescriptions type of minor tranquilizers (andaxin, trioxazin and so on).
Cm. also Affective syndromes, Delusional syndrome, Hallucinatory syndromes, Consciousness (disorder).