A group of disorders, which are psychotic reaction to insoluble and intolerable stressful situations. All neurotic disorders are reversible, however, tend to be protracted course. Despite the absence of severe mental disorders, neurosis significantly impair the quality of life of patients and their emotional state affect adversely limit the possibility of professional realization and construction of safe personal relationships.
Accurate data on the prevalence of neurotic disorders are absent. According to official statistics, neurotic suffering 0.4-0.5% of the population, however, in the field of psychology and psychotherapy experts are critical to this figure, noting that it reflects only cases posing health patients in the public hospitals. Thus, remain unaccounted for patients undergoing treatment in numerous private psychological and psychotherapeutic centers. Do not forget that a significant portion of patients suffering from neurosis, does not refer to the psychologists and psychotherapists, ashamed of his “weakness” or rastsenivaya manifestations of the disease as a particular individual.
obsessive-compulsive disorder, hysterical neurosis and asthenic neurosis (old naming – neurasthenia), but this classification is at odds with the practice. For example, it is not reflected in one of the most common groups today neuroses – anxiety disorders, selected ICD-10 as a separate syndrome.
This discrepancy creates different approaches to the systematization of neuroses. When the diagnosis in clinical practice, many experts prefer to use the classification, created by taking into account the causes of development and prevailing symptoms. In this classification distinguishes between the following levels of neurotic disorders:
- Anxiety and phobic disorders. The main symptom of the disease is a sharp increase in the level of anxiety, sometimes turning into a phobia. The group of such disorders include generalized anxiety disorder, panic attacks, agoraphobia, claustrophobia, social phobia and other simple and complex phobias.
- Obsessive-compulsive disorder. The main symptom is obsessions and compulsions.
- Asthenic neurosis (Neurasthenia) – neurotic disorder, the clinical picture dominated asthenic syndrome.
- Somatoform Disorders. According to clinical manifestations of such disorders resemble somatic diseases, but does not have a sound physical basis. In contrast, patients with factitious disorders, patients with somatoform disorders are not taking any action to simulate disease and really feel unpleasant symptoms.
- Dissociative disorders . This group includes the dissociative disorders of movement and sensation, and other similar disorders of neurotic level, previously worn naming hysterical neurosis.
Dizziness, feeling of instability, trembling limbs, muscle twitching, muscle cramps, increased heart rate, pain and discomfort in the chest, increase or decrease in blood pressure, feeling cold or hot, a feeling of suffocation, lack of air or incomplete inhalation, yawning, eating disorders, various dyspepsia, frequent urination, pain, itching and discomfort in the perineum, sweating, chills, and a slight rise in temperature wanton. Characteristic features of autonomic disorders is their impermanence and polysystemic.
With all neurotic disorders observed sleep disturbances: difficulty falling asleep because of the thoughts related to the traumatic situation, or because of excessive acute perception of any external signals (the ticking of clocks, street noise, steps from neighbors sounds), frequent awakenings, shallow sleep, bright or nightmares, feeling of weakness, and weakness after a night’s sleep. Often the patient is suffering from sleepiness during the day, and at night – from insomnia.
Another symptom of neurosis is an obligate asthenia. Patients suffer bad load quickly depleted. Neurotic disorders are accompanied by mood instability, irritability and decreased efficiency of varying severity. He suffers and sexual side of life for patients – sexual desire disappears or is reduced, decreasing the duration of sexual intercourse, sexual contacts not bring the former satisfy, there are a variety of disorders (disorders of potency, premature ejaculation).
When neurotic disorders observed affective disorders. The general background of declining mood, the patients feel sadness, depression and hopelessness. Familiar fun (great food, hobbies, socializing with friends and family), previously brought joy, become indifferent. The circle of interests is narrowed, patients become less sociable and begin to avoid contact with other people. Often they develop depression or subdepression. Increased levels of anxiety. Patients see the future unfavorable disadvantaged. They live in anticipation of an uncertain catastrophe tend to focus excessively on the negative case scenarios.
In contrast to the above manifestations of neurosis, phobias and obsesii not occur in all patients. These two features are closely related, but the clinical picture, usually one of two predominant symptoms. Obsessions are involuntary obsessive thoughts, impulses, fears and memories. To get rid of obsessions, patients perform compulsive actions often take the form of complex rituals.
Phobias called obsessive fears of objects or situations is not currently represent a real danger for the patient. There are three types of phobias: simple phobia (fear of spiders isolated, flight, birds, clowns and pr.), agoraphobia (fear of open spaces, places that can not leave quietly, and situations in which you can go without assistance) and social phobia (fear of situations in which the patient is at the center of attention of others).
psychological testing using specific standardized questionnaires (BVNK-300 adaptation Bakirova, 16-factor questionnaire Cattell and so on. n.). In the process of diagnostics exclude organic pathology, which could provoke the appearance of psychological disorders and somatovegetativnyh. If necessary, the patient is directed to consult a neurologist, internist, cardiologist, gastroenterologist, endocrinologist and other specialists prescribe brain MRI, EEG, ECG and other tests.
The main method of treatment of neurotic disorders is psychotherapy. Use psychoanalysis, cognitive-behavioral therapy, Erickson hypnosis, integrative transpersonal therapy, psychodynamic therapy and other methods. The goal of therapy – identification of conscious and unconscious mechanisms of adaptation and their subsequent correction. psychotherapy carried out against the background of medical support if necessary. Depending on your symptoms using tranquilizers, antidepressants, and antipsychotics.
Assign a restorative treatment, which includes physiotherapy, massage, vitamins and trace elements. Of great importance is lifestyle change: respect for work and rest, moderate exercise, stay in the open air, a balanced diet, avoiding harmful habits. Sometimes you need a change of activity. With timely treatment of early favorable prognosis. The symptoms disappear, patients return to normal life, but in severe stress relapses. Late-treatment and failure to comply with the doctor’s recommendations there is a tendency to a prolonged duration.