Exogenous (symptomatic and exogenous-organic) psychoses and concomitant non-psychotic disorders

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Psychiatry and diagnostics in psychiatry

What diagnostic methods in psychiatry are the most informative? How is diagnosis done? Modern psychiatry, what is it?

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Psychiatry is the most powerful area both in our clinic and in modern medicine. We not only provide treatment and diagnosis of various mental disorders, but also study the occurrence of mental illnesses and the connection with physical diseases. We develop and implement more effective methods of combating diseases of the nervous system. Modern private psychiatry is not punitive medicine. We are interested in a clear personal approach to each patient. Modern drugs that we use in our practice have minimal side effects. We individually select medications that not only relieve negative symptoms, but, most importantly, effectively treat diseases.

The conditions created in the clinic are extremely important for patients with both endogenous mental disorders and borderline mental states. We make every effort to ensure that our patients do not receive drug treatment for a long time or for life.

We use the latest developments in the field of psychopharmacology, which offers increasingly safe and more effective drugs. Working together with psychiatrists, we are interested in obtaining medications that can relieve an acute mental state quickly, depress the patient’s psyche as little as possible, and allow a person to work effectively and have a family.

Who treats mental illness

In our clinic, highly qualified psychiatrists, psychotherapists and clinical psychologists diagnose and treat mental disorders.

Our specialists identify the true causes of mental illness and establish connections with hereditary and stress factors. We use only an individual approach to each person, taking into account his general health and social environment.

A psychotherapist is involved in the treatment of the patient at the rehabilitation stage. Works with the causes of the disease, helps the patient better understand and control his condition.

A clinical psychologist conducts psychological testing, which helps the doctor understand the patient’s personality traits and the severity of mental changes. She also deals with psychocorrection of the mental state during the recovery period.

Classification of diseases in psychiatry

Mental illness can be caused by a variety of factors. Official psychiatry identifies three main reasons.

1. Endogenous disorders.
2. Psychogenic factors.
3. Organic changes.

Up to 40% of the planet's population suffers from one or another mental disorder. Psychiatry often appears to the inexperienced person as something mysterious and vague. In Russia, it is customary to hide a psychiatric diagnosis because it causes condemnation and rejection in society. However, mental illness is a common disease that is treated according to its own rules.

No one is embarrassed by such complex diseases as diabetes or bronchial asthma. Despite the fact that one of the complications of these diseases can be mental disorders. A number of progressive doctors and scientists attribute all chronic diseases, which include some mental pathological conditions, to the peculiarities of the formation of the body. Such disorders often require constant medication, medical supervision and adherence to a certain lifestyle.

Psychiatry

Likewise, mental illness refers to an unusual state of the psyche, which often requires constant use of stabilizing drugs and special organization of life. If all the doctor’s recommendations are followed, a mentally ill person can continue to live his normal life.

Unfortunately, mental illness during the period of exacerbation reduces the patient’s criticism of his condition. The patient often stops taking the pills and refuses to visit the doctor. In this case, the closest relatives should take the initiative by inviting a psychiatrist to the home or taking him to an appointment with a doctor.

We are mainly talking about diseases of the so-called “Big Psychiatry”.

List of psychological diseases

Mental disorders are quite common nowadays. Often they do not have a clear clinical picture. However, you should not neglect them completely. If you make a list of psychological diseases, it will turn out to be quite extensive. Nowadays, the concept of normal is interpreted quite broadly, however, if the symptoms are pronounced, you should not postpone a visit to the doctor, since delaying it over time will only worsen the situation.

In this regard, the list of psychological diseases makes sense for specialists and medical professionals, as a reference book. In everyday life it is not of great value, since without special training it is very easy to get lost in it. From a practical point of view, it makes sense to talk about a list of mental illnesses and their signs for which you should immediately visit a doctor.

Here is a list of the most dangerous and common diseases:

• obsessive-compulsive disorder;
• dementia;
• schizophrenia;
• addiction to drugs and alcohol;
• neurasthenia;
• patient's personality disorder;
• various types of phobias;
• reaction to persistent or severe stress.

It is worth clearly recognizing that the sooner the patient is in the hands of a specialist, the higher the outcome for a successful course of the disease or his full recovery.

Great psychiatry

Major psychiatry studies, diagnoses and treats mental illnesses associated with disorientation and gross pathology of the mental sphere: delusions, hallucinations, profound dementia, long-term and persistent decrease or increase in mood. This is a group of endogenous mental illnesses, the cause of which is unknown and is often inherited.

Minor psychiatry identifies the causes and treats so-called borderline mental illnesses. These are states on the border of normality and pathology, associated with experiencing unfavorable situations and stress.

So, psychiatry is divided into major and minor, and mental illnesses: into endogenous, exogenous (psychogenic and organic).

Endogenous mental disorders

• Schizophrenia – a change in the patient’s thinking and personality, emotional impoverishment and loss of will, often accompanied by delusions and hallucinations;
• Epilepsy is a mental disorder with an angry-spiteful mood;
• Endogenous depression is a deep and persistent low mood for no apparent reason;
• Bipolar affective disorder - alternating phases of high and low mood, may be accompanied by delusions and hallucinations;
• Personality disorders (psychopathy) are persistent character pathologies that prevent a person from adapting to society;
• Dementia (senile dementia and Alzheimer's disease) is a decrease in memory and intellectual abilities due to damage to the cerebral cortex.

Exogenous mental disorders and borderline states

• Neurosis is a completely reversible borderline mental state. The manifestations of neurosis are diverse, including fears and anxiety, weakness and fatigue, mood instability and sensitivity, multiple vegetative manifestations: sweating, difficulty breathing, headaches, dizziness, discomfort in different parts of the body. Neuroses make up 80% of all mental illnesses.
• Exogenous psychoses are acute mental conditions associated with brain damage, trauma, intoxication or infection.
• Reactive psychoses are acute short-term disturbances of mental activity, often with delusions, hallucinations and mood lability against the background of an acute mental traumatic factor.
• Organic disorders are the consequences of brain damage of a vascular or other nature.
• Mental disorders in connection with somatic diseases are mental deviations against the background of chronic physical illnesses.
• Somatoform disorders (organ neurosis) are mental conditions where functional bodily manifestations occur along with mental symptoms.
• Psychosomatic diseases - include a number of somatic diseases, where a mental factor causes and, in the future, aggravates an existing physical disorder.

Psychosomatic

• Hypertonic disease;
• Bronchial asthma;
• Peptic ulcer of the stomach and duodenum;
• Diabetes;
• Coronary heart disease, angina pectoris;
• Ulcerative colitis;
• Hyperthyroidism.

Diagnostic features

A mental health diagnosis is made through interview, observation, and medical history. Laboratory and instrumental diagnostic methods are necessary only to exclude somatic or organic (neurological) disease. Pathopsychological testing is often used to obtain objective indicators of a person’s thinking, intelligence, mood and behavior.

In addition, various drug addiction problems can be the cause of mental disorders.

Diagnostics in psychiatry

Psychiatry and psychiatrists are often reproached for not having objective diagnostic methods in their arsenal. The diagnosis of a mental disorder is made “by eye” - based on a conversation with the patient and relatives, without the use of complex instruments and tests. In an era when medicine is increasingly associated with high technology, this approach causes natural mistrust.

That is why we decided to tell you in more detail how diagnostics occur in psychiatry.

Test for psychological diseases

There are a huge number of different tests. When familiarizing yourself with specialized resources, it is easy to get lost in their diversity. However, it should be firmly understood that any test for psychological diseases does not provide a 100% guarantee of the accuracy of its results.

A large number of tests have been developed to identify mental characteristics. Some are intended for self-diagnosis, others claim to be of a professional level, some are complex, only for specialists, but you should firmly understand the rule: interpretation of test results and conclusions should only be made by a doctor specializing in this field.

With the spread of computers, many tests became famous. Many people have heard about the Luscher color test, the Eysenck method (identification of temperament), the Rorschach test (inkblot test) or Szondi (recognition and perception of portrait images). The listed tests are most often used by psychiatrists and psychologists.

There are also various forms of testing. Most in demand:

• questionnaire, analogous to a simple questionnaire. Questions and short answer options are provided;
• task, human actions are studied during its implementation;
• projective test, when the subject is placed in a simulated situation.

Reasons for visiting a psychiatrist

• The first and “most understandable” reason is all kinds of stress, difficult life situations. This is exactly how ending up in a psychiatric hospital or just visiting a psychiatrist is usually portrayed in films and literature. Also popular are media statements that “in our time” there is more and more stress and the number of mental disorders is growing. In fact, the role of stress in the occurrence of mental disorders is very modest. Stress actually leads to the development of neuroses - diseases associated with excessive anxiety can cause depressive disorders, but almost never lead to the development of serious mental pathology. The most common mental disorders - schizophrenia, bipolar disorder - are not associated with stress!
• The second, and also relatively “understandable” reason, is the action of factors that directly damage the brain. Such diseases are usually called “organic”. External factors are alcohol, drugs, trauma, brain tumors. Epilepsy belongs to the same group of disorders. All these external factors lead to certain changes in the psyche - decreased memory, intelligence, emotional disorders, but extremely rarely lead to the development of psychoses - severe mental disorders accompanied by delusions and hallucinations. Delusions and hallucinations can occur when taking drugs, but usually do not last long.
• The third, and “little understood” reason is an imbalance of neurotransmitters in the brain. Such diseases are called “endogenous”, which in Greek means “internal”. This reason is “little understood” because the imbalance of neurotransmitters occurs as if “suddenly,” “out of the blue,” without connection with stress or any external factors. And yet, these are the most common mental disorders. It is endogenous disorders that include the most common mental disorders - schizophrenia, bipolar disorder, and related diseases.

The meaning of diagnosis

Thus, the meaning of diagnosis in psychiatry, first of all, is to determine which of the three reasons brought the patient to the appointment. Based on the above, it becomes clear what is of paramount importance for making a psychiatric diagnosis:

• The connection between the appearance of symptoms and any external factors - stress, head injuries, drug use.
• The symptoms themselves. Severe mental disorders - delusions, hallucinations - are almost always a sign of endogenous disorders.

What is the place of “objective” research - analysis, instrumental research in psychiatry?

Psychological diseases in children

No one spends as much time with children as their parents. Therefore, they have the greatest chance of identifying psychological diseases in children. Professional psychologists name the main signs by which one can judge the degree of need for medical care for a child:

• a sharp increase in the number of problem situations at school;
• your child is being abused or bullied by other children;
• the child commits actions that harm himself;
• avoids friends, avoids communication with family;
• frequent and sudden mood swings;
• your child is overcome by very strong emotions, such as anger, panic;
• ensuing apathy, lack of motivation to act;
• the child cannot concentrate on necessary matters;
• insomnia or nightmares;
• constant complaints of poor physical well-being;
• neglect of one's appearance;
• strong feelings about your appearance, a constant feeling of dissatisfaction with your appearance, figure, weight;
• appetite differs significantly from the norm in one direction or another.

If your observations are confirmed by a specialist, you should not lose your composure or panic. Remember, the child sees support in you and therefore you must remain strong in his eyes.

Hardware diagnostics in psychiatry

• MRI (magnetic resonance imaging) - allows you to determine the presence or absence of a brain tumor, stroke, or injury. As you can see, all these situations relate more to neurology and are usually accompanied by neurological disorders - headaches, speech disorders, gait, and sensitivity. At the same time, mental disorders themselves - delusions, hallucinations, phobias, obsessions, etc. They are not typical for organic disorders and are not accompanied by any changes on MRI.
• EEG (electroencephalogram) - a recording of the electrical activity of the brain - is a more subtle method of diagnosing mental disorders. In its simplest form, an EEG can answer only one question - whether the patient has signs of epilepsy or not. Mental disorders themselves are not accompanied by EEG changes. At the same time, if an inquisitive reader searches for information on the Internet, for example, by entering “EEG and schizophrenia” in the search bar, he will see a lot of articles, often in English, devoted to EEG changes in mental disorders. A contradiction appears - on the one hand, EEG is used to diagnose epilepsy alone, and on the other hand, so much data has been accumulated in the world on EEG changes in mental disorders.

This contradiction is resolved as follows. In all these studies, the patient did not just have an EEG taken, but certain experimental techniques were performed on him. For example, they presented him with various pictures, asked him to perform certain tasks related to the classification of concepts and objects, comparison of their properties, in other words, the EEG was recorded against the background of certain mental activity, which made it possible to further analyze various indicators of the electrical activity of the brain.

In all these experiments, the initially obtained EEG data was subjected to complex computer processing, which made it possible to determine the activity of certain areas of the brain, establish functional connections between them (due to electrical synchronization), and draw up a kind of “map” of such connections. It was in this difficult way that data was accumulated on various kinds of changes and anomalies accompanying mental disorders.

Analysis and psychiatry

Analyzes. It would seem that if the main cause of mental disorders is an imbalance of neurotransmitters (dopamine, serotonin, glutamic acid), then it seems most logical to determine the concentration of these substances in the blood. This can be done, moreover, this “service” is practiced by some clinics and some psychiatrists. But, alas, in fact, the concentration of neurotransmitters in the blood does not reflect their content in the brain and therefore is not informative and does not provide anything for diagnosis. The reasons for this are the blood-brain barrier - the boundary that exists between brain tissue and blood, as if separating the brain from the rest of the body. Thus, it would be possible to determine the concentrations of these substances directly in the brain, but for this it would be necessary to make holes in the skull, and in several places, but this seems traumatic and impractical.

Previously, we have repeatedly drawn attention to the position occupied in psychiatry by diseases of the brain, designated as exogenous-organic. On the one hand, they are considered as an extremely relevant mental pathology in medical and social terms, on the other hand, they receive extremely little attention (it even decreases over time). The last statement is based on our analysis of relevant journal publications. There is evidence [1] that it is precisely this approach that allows us to reproduce the picture of the interests of specialists involved in certain scientific problems.

We studied the contents of sets of nine domestic psychiatric journals published over a 5-year period - from 2011 to 2015. These were the “Journal of Neurology and Psychiatry named after. S.S. Korsakov”, “Social and Clinical Psychiatry”, “Siberian Bulletin of Psychiatry and Narcology”, “Psychiatry”, “Russian Psychiatric Journal”, “Independent Psychiatric Journal”, “Review of Psychiatry and Medical Psychology named after. V.M. Bekhterev", "Mental health", "Psychiatry and psychopharmacotherapy named after. P.B. Gannushkina".

The frequency of publication of magazines is from four to twelve per year. Each issue contains from 15 to 20 articles. In just 5 years, according to our calculations, 4090 articles were published. It turned out that only 43 (1.05%) of them reflected certain aspects of exogenous organic pathology. Moreover, only the title of seven articles contained a direct indication that their topic was devoted to exogenous organic diseases. Their share in the total volume of publications was only 0.17%, and among articles on “organic” topics - 16.3%. In the set of one of the above-mentioned journals there were no works devoted to exogenous organic pathology at all.

These assessments are largely consistent with the results of our analysis of materials from the largest Russian psychiatric forums - the XV and XVI Congresses of Russian Psychiatrists (2010 and 2015). The theses of the XV Congress did not contain a section called “exogenous-organic” at all, and the pathology it designated was actually absorbed into the extensive section “Organic mental disorders and epilepsy. Neuropsychiatry". Moreover, in this section, out of 37 publications, only three (8.1%) had this term in their titles. In the theses of the XVI Congress, although the section “Exogenous-organic mental disorders and epilepsy” was highlighted, out of the 37 works included in it, only two (5.4%) were directly related to exogenous-organic diseases.

Definitions.

One of the key issues in psychiatry that remains without due attention is the question of the semantic content of the term “exogenous-organic”. The fact is that, despite the seemingly accepted and well-established content in Russian psychiatry, this term denotes far from homogeneous mental disorders. As a result, the essence of mental disorders called “exogenous-organic” in certain publications can be judged only by the text, but not by the names adopted in these articles. Therefore, this term turns out to be uninformative, which practically excludes it from the conceptual apparatus of psychiatry.

In accordance with the above, it becomes obvious that it is necessary to develop clear definitions regarding the term “exogenous-organic” and, accordingly, coordinated approaches to painful forms with this name. However, this, naturally, can only be feasible with a broad discussion of this issue, which we have repeatedly proposed previously [2-4]. Neither before nor subsequently have we come across publications in which this issue was addressed. In this regard, we consider it advisable to return to it again.

We have established that in psychiatry there are at least three significantly different interpretations of the concept “exogenous-organic”.

The term “exogenous-organic” was first used by P.B. Posvyansky in 1942 in his work “Towards the doctrine of the propagated exogenous-organic type of reaction (type of process). Message 1,” published in the journal Neuropathology and Psychiatry [5]. He was the first to define these forms of pathology: “Under the protracted exogenous-organic types of reaction (or process), we combine those exogenous-organic psychoses that are caused by numerous harmful effects, acute or chronic, that produce more or less gross changes in the brain, and the latter, in turn, when the rate of progression of the disease slows down, determines the spontaneous course of psychoses, a course that is no longer directly related to the primary producing cause.” In schematic form, the concept of P.B. Posvyansky can be presented in the form of a chain of cause-and-effect relationships: exogenous pathogenic factor - organic brain damage - exogenous-organic brain disease (exogenous-organic mental disorders).

We find the second version of the interpretation of the concept under consideration in F.I. Ivanov [6]. He classified mental disorders during the immediate consequences of injuries and other severe brain damage as exogenous-organic. According to the author, they occupy an intermediate position between typical exogenous and
organic phenomena
and largely retain the features of disorders in the initial stages of brain damage, but at the same time acquire signs of an emerging organic defect.

The third version of the definition of exogenous-organic forms of pathology was given in expanded form by V.V. Kovalev: “In cases of psychotic disorders that arise in direct connection with cerebral-organic diseases (meningitis, encephalitis, traumatic brain injuries, toxic encephalopathies, brain tumors, etc.), it is more correct to talk about exogenous-organic psychoses” [7] . In general, V.V. Kovalev gives the term a broad meaning, since he classifies as exogenous-organic mental disorders of acute, subacute and long-term periods of brain infections and injuries, i.e. disorders that develop at all stages of the formation of organic brain damage

.

Without disputing the legality of using the term “exogenous-organic” in all the given meanings, we consider P.B.’s interpretation more justified. Posvyansky, the essence of which, as already noted, is to identify mental disorders caused by organic damage to the brain, formed as a result of previously suffered or existing exogenous factors. It is this interpretation that reflects the etiology and pathogenesis of the forms of mental pathology under consideration.

We cannot help but refer to the assessments of V.N. Krasnova: “...the concept of “exogenous-organic”, introduced by P.B., deserves recognition of heuristic significance. Posvyansky and reflecting not only the fact of primary exogenous influence with the corresponding types of reaction (according to Bongeffer), but also the dynamic characteristics of disorders, including secondary cerebral changes, which in themselves can constitute the cause and determine the nature of subsequent clinical manifestations” [8].

Clinical structure

exogenous-organic mental disorders require the attention of specialists. The fact is that in psychiatry the idea of ​​pronounced polymorphism of organic mental disorders has taken root, which is reflected in the works of many authors [9-13]. According to them, organic diseases of the brain are characterized by the greatest polymorphism - the largest range, range of syndromes [14], including almost all psychopathological phenomena known in psychiatry, observed in the picture of all nosological forms - from neuroses to schizophrenia and epilepsy.

Along with this, the results of a number of epidemiological studies [4, 15, 16] indicate that the range of psychopathological syndromes of exogenous organic origin is quite limited.

The main manifestation of these forms of pathology is a psychoorganic syndrome, against which epileptic, depressive and delusional states, hallucinatory phenomena, hypochondriacal and obsessive phenomena can develop. However, this circle is not characterized by syndromes of impaired consciousness (except for twilight), manic, catatonic and hebephrenic states, and mental automatisms. If any occur, then we are most likely talking about a combined exogenous-organic and endogenous pathology, or reactions of an exogenous type are taken as exogenous-organic.

Prevalence

exogenous-organic diseases of the brain are characterized by a large discrepancy in indicators, which is explained by different research methods and populations of those examined. It is only important to note that exogenous-organic mental disorders are a common form of mental pathology.

Among patients newly diagnosed, as follows from the work of A.A. Churkin and N.A. Tvorogova [17], in the group of psychoses organic pathology predominates (56.3%), and in the group of non-psychotic disorders it ranks second (28.5%) after neurotic disorders. At the same time, there is reason to believe that there is a significant number of unregistered patients. N.M. Zharikov and V.Ya. Gindikin [18], having studied the prevalence of borderline mental disorders among workers of industrial enterprises not under the supervision of psychiatric institutions, found organic disorders of various nature in 15.2% of them. True, in these cases it should be taken into account that the authors of these works did not differentiate organic pathology. Our joint with A.A. Primochenok's [19] study of a large group of adolescents - high school and vocational school students who were not registered with the psychiatric service - revealed signs of exogenous organic brain diseases in 25.9% of them of varying degrees of severity.

An increase in the number of patients with exogenous organic diseases in the population may be associated with an increase in the scale of adverse environmental impacts and the emergence of new types of them.

Exogenous-organic mental disorders and combined forms of mental pathology.

The problem of exogenous-organic mental disorders is closely related to the little-studied problem of combined (comorbid) forms of various diseases. Without dwelling on the essence of this phenomenon, we note the large proportion of combined forms. To illustrate this point, we present the results of some of our studies: 40.0-50.0% of patients with alcoholism have exogenous-organic mental disorders of non-alcoholic origin; in 20.0-30.0% of patients with neuroses, exogenous organic symptoms are detected. L.V. Leshchenko [20] showed that 21.0–33.9% of patients with schizophrenia have exogenous organic diseases of the brain.

Combined forms of mental pathology, including those including exogenous-organic mental disorders, have their own clinical and dynamic patterns, which require the development of special standards for the organization of effective treatment and rehabilitation care. These forms also require detailed study in relation to expert practice [21].

Ways to solve the problem of exogenous organic brain diseases

multifaceted. One of them lies in line with the general psychiatric problem - the creation of an acceptable classification of mental illnesses that meets clinical and theoretical requirements, which would include exogenous organic pathology. Let us note that in the classifications of a number of well-known psychiatrists [9, 22–24], special sections were dedicated to it. In ICD-10, which has become not only a statistical but also a diagnostic tool, there is no section devoted to exogenous organic diseases.

Currently, the next version of the ICD (ICD-11) is being developed. Moreover, as discussions among the psychiatric community show, it, like the previous one, will not contain headings related to exogenous organic diseases of the brain. In this regard, the conclusion suggests itself about the need to create a national classification of mental illnesses, in which exogenous-organic mental disorders would occupy a prominent place. The validity of our opinion is confirmed by the judgments of other experts. In particular, B.D. Tsygankov and S.A. Ovsyannikov [25], raising the question of the classification of mental illnesses for use in pedagogical work and in conducting scientific research, write: “With an obvious overabundance of described disorders that are very unconvincing in terms of diagnosis, ICD-10 does not include a special category for the group of exogenous-organic psychoses, the existence of which has long become a real clinical fact.” V.B. Holland and B.A. Kazakovtsev [26], among the proposals for the next revision of the ICD, indicate the need to develop a conceptual apparatus for diagnosing exogenous organic disorders. Yu.S. Shevchenko [27] proposes the creation of a domestic classification of mental illnesses based on the etiopathogenetic model and provides for the identification of an “exogenous-organic vector” in it. I.V. Makarov [28] includes exogenous organic mental disorders in the group of organic psychoses in children and adolescents.

Justifying the need to create a national classification of mental illnesses containing a section of exogenous-organic pathology, we do not assume that it can be a replacement for the ICD-11 being developed. This option is naturally excluded. Along with this, there is a relatively simple and productive way out of this situation: to make changes and amendments to highlight a group of exogenous-organic disorders in Class V of the ICD “Mental disorders and behavioral disorders,” adapted for use in the Russian Federation. Our proposal has real foundations, since it is based on certain experience of this kind. At one time, such work was done in relation to ICD-10 [29], although its results were not implemented for various reasons.

Accurate diagnosis in psychiatry

So, the most effective and efficient method for diagnosing major mental disorders today remains the clinical-psychopathological method - talking with the patient, observing him, collecting information about his life. Pathopsychological examination is also an important help. This is a set of techniques that allow you to study in detail the associative process, the process of generalization, and identify thinking disorders characteristic of mental disorders.

At the end of the article, we note that diagnostics in psychiatry is not based on the principle of detecting certain oddities in the patient’s behavior that distinguish him from the norm from a philistine point of view. We are not trying to answer the question, “Is the patient normal?” Normal is indeed a flexible concept; very often strange behavior is inherent in absolutely healthy people and can be associated with shocking behavior, special beliefs, worldview, etc.

The psychiatrist, first of all, tries to answer the question, “Is the person sick?” In contrast to the broad and difficult to define concept of norm, the concept of disease in psychiatry is strictly defined and regulated. Diagnostics is not based on detecting oddities, but on detecting characteristic symptoms and their combinations. Contrary to the common phrase that “everyone goes crazy in their own way,” mental illnesses develop according to strict patterns. The psychiatrist’s task is to detect the presence or absence of these patterns.

Modern approach in psychiatry

Inpatient or outpatient treatment in a private psychiatric clinic has shown high results in the treatment of exogenous mental disorders and a persistent long-term effect in stabilizing endogenous mental illnesses. Complex treatment from several specialists at once: a psychiatrist, neurologist, psychotherapist and psychologist makes it possible to cover the entire sphere of manifestations of mental illness. Early inclusion of psychotherapy, as the main method of treatment for many mental illnesses, allows the patient to quickly realize his illness and find an approach to its cure. The use of special physiotherapy and healing procedures can quickly bring a weakened mental patient back to normal.

In state psychiatric hospitals, there are at least 40-60 patients in the departments, or even more. Psychiatrists try to take on an additional workload, working at 1.5-2 times the rate in order to provide themselves with a minimum salary. That is, usually there are only 2 doctors per department. This approach is unlikely to allow the necessary time to be devoted to each patient. And psychotherapeutic assistance is practically not provided in state psychiatric institutions.

In a private psychiatric clinic, there are a maximum of 5-6 patients per doctor. This makes it possible to devote a large amount of time not only to a careful diagnosis of the condition, but also to approach each patient individually. More comfortable hospital conditions and nutritious nutrition make the hospital stay less stressful. And the inclusion of additional procedures enhances the effect of drug therapy.

Psychiatry and drugs

Paid treatment for mental illness allows you to choose only the best medicines from a large arsenal of modern psychotropic drugs. Selective antidepressants make it possible to individually select treatment for different categories of patients.

Modern antipsychotics can be used without corrective drugs. They are more easily tolerated and patients are less burdened. Neuroleptics of the latest generation make it possible to achieve the expected therapeutic effect in a shorter period of time. Effective treatment with modern antipsychotic drugs gives a positive result not only in removing acute psychotic symptoms, but also correcting the emotional-volitional sphere of the patient. Thus, the patient has a real opportunity to return to work again.

The use of modern sedatives allows them to be used for a longer period of time due to the lack of addiction to them.

The neurometabolic approach to treating mental illness helps the brain recover more quickly from the stress of mental illness.