bipolyarnoe affektivnoe rasstroystvo

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psychosis and mood disorders: reasonable expectations for treatment outcomes bipolyarnoe affektivnoe rasstroystvo maniakalno-depressivniy psixoz gans xristian andersen onore de balzak ernest xeminguey german gesse gektor berlioz georg fridrix gendel viktor gyugo sergey raxmaninov istoriya voprosa hippocrates “melanxoliya”, “chernaya jelch” theophile bonet: “manico-melancolicus” j. falret and baillarger: “tsirkulyarnoe pomeshatelstvo” emil kraepelin “maniakalno- depressivnoe zabolevanie” * istoriya voprosa 1890 g. jan falre i jyul bayyarje «pomeshatelstvo dvoynoy formi» («folie a double forme») 1898 g. emil krepelin maniakalno-depressivniy psixoz 1960 g. jyul angst i djodj vinokur bipolyarnoe affektivnoe rasstroystvo maniakalno-depressivniy psixoz endogennoe psixicheskoe zabolevanie, kotoroe xarakterizuetsya nalichiem faznix affektivnix rasstroystv i periodov intermissiy (svetlix promejutkov), kogda psixicheskoe sostoyanie patsientov prakticheski ne otlichaetsya ot psixicheskogo sostoyaniya zdorovogo cheloveka. ambulatorniy (smyagchenniy) variant mdp – tsiklotimiya. rasprostranennost rasprostranennost sredi naseleniya 0,5 - 0,8% chashe vsego boleyut jenshini, sootnoshenie ot 3:1 do 5:1 naibolee chasto bolezn nachinaetsya v zrelom vozraste etiopatogenez nasledstvennoe predraspolojenie: risk zabolevaniya mdp u …

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oterya interesa k seme, druzyam, rabote, seksu nevozmojnost poluchat udovolstviya, veselitsya – angedoniya depressiya mishlenie zamedlennost mishleniya, trudnosti pri kontsentratsii, prinyatii resheniy misli o neudachax, ponijennaya samootsenka, nevozmojnost pereklyuchitsya s misley negativnogo soderjaniya poterya oshusheniya realnosti, vozmojno poyavlenie gallyutsinatsiy i bredovix idey depressivnogo soderjaniya suitsidalnie misli (okolo 15% ne lechennix patsientov s affektivnimi zabolevaniyami sovershayut suitsid) depressiya fizicheskoe sostoyanie izmenenie appetita i vesa (70% teryayut ves, drugie nabirayut); inogda razvivaetsya chrezmernoe stremlenie k sladkomu narusheniya sna: xotya insomniya yavlyaetsya chastoy jaloboy, okolo 15-30 % chuvstvuyut povishennuyu potrebnost vo sne, i oni ne chuvstvuyut sebya otdoxnuvshimi daje posle 12-14 chasov sna poterya energii, slabost, sonlivost razlichnie bolevie oshusheniya (golovnie, mishechnie boli) gorkiy privkus vo rtu, nechetkost zreniya, narusheniya pishevareniya, zapori ajitatsiya i bespokoystvo depressiya povedenie zamedlennaya rech, dvijeniya, obshaya «zatormojennost» chrezmernaya plaksivost ili , naoborot, otsutstvie slez daje pri jelanii plakat zloupotreblenie alkogolem i/ili narkotikami nekotorie tipi depressivnix sindromov melanxolicheskaya depressiya …

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pravilo eto nastroenie narastaet v opredelennoy dinamicheskoy posledovatelnosti, kotoroe vklyuchaet posledovatelnuyu smenu sleduyushix faz: pod'em nastroeniya v predelax normi : schaste, radost, vesele umerenniy pod'em: povishennaya samootsenka, povishennaya trudosposobnost, aktivnost, snijenie potrebnosti vo sne maniya: maniakalnie simptomi narastayut i nachinayut narushat normalnuyu sotsialnuyu aktivnost bolnogo «bredovaya» ili psixoticheskaya maniya: chrezmernaya sverxaktivnost, razdrajitelnost, vrajdebnost, vozmojna agressiya, bredovie idei i gallyutsinatsii maniya emotsii povishennoe nastroenie, chuvstvo pod'ema, eyforii, ekstaza razdrajitelnost, zlobnost, chrezmernoe reagirovanie na obichnie veshi labilnost, bistraya smena nastroeniya: oshushenie schastya i cherez minutu zlost bez kakoy-libo vidimoy prichini vrajdebnost maniya mishlenie povishennaya samootsenka, idei velichiya, sobstvennogo mogushestva nepravilnaya interpretatsiya sobitiy, privnesenie sobstvennogo smisla v kommentarii obichnogo soderjaniya otvlekaemost, otsutstvie kontsentratsii skachka idey, polet misley, pereskakivanie s odnoy temi na druguyu nedostatochnost kritiki k svoemu sostoyaniyu poterya oshusheniya realnosti, vozmojno poyavlenie gallyutsinatsiy i bredovix idey maniya fizicheskoe sostoyanie povishennaya energiya ukorochenie sna – inogda bivaet dostatochno tolko 2 chasov sna obostrenie …

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sstroystva nastroeniya) epizodi rasstroystva nastroeniya predstavlyayut soboy kombinatsiyu simptomov (maniakalnix ili depressivnix) sostavlyayushix dominiruyushee affektivnoe sostoyanie tipi epizodov (ili pristupov) 1. depressivniy 2. maniakalniy 3. smeshanniy affektivnie rasstroystva opredelyayutsya nalichiem epizodov rasstroystva nastroeniya bipolyarnoe rasstroystvo v dsm-iv bipolyarnoe rasstroystvo i tipa po krayney mere, 1 maniakalniy ili smeshanniy epizod bolshie depressivnie epizodi xarakterni, no ne obyazatelni bipolyarnoe rasstroystvo ii tipa po krayney mere,1 gipomaniakalniy epizod (dlitelnostyu 4 dnya) i, po krayney mere, 1 bolshoy depressivniy epizod otsutstvie maniakalnix epizodov tsiklotimiya dlitelnie (>2 let) depressivnie i gipomaniakalnie epizodi otsutstvie bolshix depressivnix ili maniakalnix epizodov bipolyarnoe rasstroystvo, neutochnennoe rekurrentnie ili sporadicheskie korotkie epizodi gipomanii (>neskolko chasov, no 25 let) bolshoe chislo predshestvuyushix epizodov (> 5) bolshaya prodoljitelnost tekushego epizoda (>6 mesyatsev) otyagoshennost po bar otsutstvie otyagoshennoosti po bar * odnovremennoe razvitie depressivnix simptomov u patsientov s bipolyarnim rasstroystvom v gipomanii yavlyaetsya chastim yavleniem smeshannaya gipomaniya nablyudalas na 76% vizitov u patsientov s …

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oystvo v svyazi s visokim riskom suitsidalnogo povedeniya v dannoy populyatsii patsientov, a takje dlitelnim periodom mejdu nachalom i pravilnim ustanovleniem diagnoza zabolevaniya. ssilki hirschfeld rm, et al. j clin psychiatry 2003;64:161-174. goodwin fk, jamison kr. 1990 suicide. in: manic-depressive illness oxford university press inc., new york, ny: 227-244. yatham ln, et al. bipolar disord 2005;7(suppl.3):5-69. el-mallakh rs, et al. psychiatr serv 2002;53:580-584. kahn d, et al. postgrad med 2000 apr, spec no: 97-104. bipolyarnoe rasstroystvo po dsm-iv i komorbidnost komorbidnie rasstroystva xarakterni dlya br obshaya komorbidnost 65% trevojnie rasstroystv a 42% zloupotreblenie psixoaktivnimi veshestvami 42% rasstroystva priema pishi 5% otsutstvie razlichiy v chastote i xaraktere komorbidnix rasstroystv mejdu bipolyarnim rasstroystvom i i ii tipov po dsm iv komorbidnie rasstroystva sochetayutsya s rannim vozrastom nachala bipolyarnogo rasstroystva, uskoreniem smeni tsiklov i bolee tyajelimi epizodami s techeniem vremeni * bipolyarnoe rasstroystvo chasto komorbidno drugim zabolevaniyam osi i. v odnom iz issledovaniy …

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psychosis and mood disorders: reasonable expectations for treatment outcomes bipolyarnoe affektivnoe rasstroystvo maniakalno-depressivniy psixoz gans xristian andersen onore de balzak ernest xeminguey german gesse gektor berlioz georg fridrix gendel viktor gyugo sergey raxmaninov istoriya voprosa hippocrates “melanxoliya”, “chernaya jelch” theophile bonet: “manico-melancolicus” j. falret and baillarger: “tsirkulyarnoe pomeshatelstvo” emil kraepelin “maniakalno- depressivnoe zabolevanie” * istoriya voprosa 1890 g. jan falre i jyul bayyarje «pomeshatelstvo dvoynoy formi» («folie a double forme») 1898 g. emil krepelin maniakalno-depressivniy psixoz 1960 g. jyul angst i djodj vinokur bipolyarnoe affektivnoe rasstroystvo maniakalno-depressivniy psixoz endogennoe psixicheskoe zabolevanie, kotoro...

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