Affective syndromes. Affective (emotional) syndromes are psychopathological conditions in the form of persistent mood changes

Affective disorders (mood disorders) are mental disorders manifested by changes in the dynamics of natural human emotions or their excessive expression.

Affective disorders are a common pathology. It often disguises itself as various diseases, including somatic ones. According to statistics, affective disorders of varying severity are observed in every fourth adult inhabitant of our planet. However, no more than 25% of patients receive specific treatment.

Lack of interest in the outside world is one of the symptoms of affective disorder

Causes

The exact causes leading to the development of affective disorders are currently unknown. Some researchers believe that the cause of this pathology lies in dysfunction of the pineal gland, hypothalamic-pituitary and limbic systems. Such disorders entail a disruption in the cyclical release of liberins and melatonin. As a result, the circadian rhythms of sleep and wakefulness, sexual activity, and nutrition are disrupted.

Affective disorders can also be caused by a genetic factor. It is known that approximately every second patient suffering from bipolar syndrome (a variant of affective disorder) had mood disorders in at least one of the parents. Geneticists have suggested that affective disorders may arise due to a mutation of a gene localized on the 11th chromosome. This gene is responsible for the synthesis of tyrosine hydroxylase, an enzyme that regulates the production of catecholamines by the adrenal glands.

Affective disorders, especially in the absence of adequate therapy, worsen the patient’s socialization, interfere with the establishment of friendly and family relationships, and reduce ability to work.

Psychosocial factors are often the cause of affective disorders. Long-term, both negative and positive stress causes overstrain of the nervous system, which is subsequently replaced by its exhaustion, which can lead to the formation of a depressive syndrome. The most severe stressors:

• loss of economic status;
• death of a close relative (child, parent, spouse);
• family quarrels.

Kinds

Depending on the prevailing symptoms, affective disorders are divided into several large groups:

1. Depression. The most common cause of depressive disorder is a metabolic disorder of brain tissue. As a result, a state of extreme hopelessness and despondency develops. In the absence of specific therapy, this condition can last a long time. Often, at the height of depression, patients try to commit suicide.
2. Dysthymia. One of the variants of depressive disorder, characterized by a milder course compared to depression. Characterized by a bad mood, increased anxiety every day.
3. Bipolar disorder. The outdated name is manic-depressive syndrome, as it consists of two alternating phases, depressive and manic. In the depressive phase, the patient is in a depressed mood and apathy. The transition to the manic phase is manifested by increased mood, vigor and activity, often excessive. Some patients in the manic phase may experience delusions, aggression, and irritability. Bipolar disorders with mild symptoms are called cyclothymia.
4. Anxiety disorders. Patients complain of feelings of fear and anxiety, internal restlessness. They are almost constantly in anticipation of impending disaster, tragedy, trouble. In severe cases, motor restlessness is noted, the feeling of anxiety gives way to a panic attack.

Diagnosis of affective disorders must necessarily include an examination of the patient by a neurologist and endocrinologist, since affective symptoms can be observed against the background of endocrine diseases, nervous system, and mental disorders.

Signs

Each type of affective disorder has characteristic manifestations.

Main symptoms of depressive syndrome:

• lack of interest in the outside world;
• a state of prolonged sadness or melancholy;
• passivity, apathy;
• disturbances in concentration;
• feeling of worthlessness;
• sleep disorders;
• decreased appetite;
• deterioration in work ability;
• recurrent thoughts of suicide;
• deterioration in general health that cannot be explained during examination.

Bipolar disorder is characterized by:

• alternating phases of depression and mania;
• depressed mood during the depressive phase;
• during the manic period - recklessness, irritability, aggression, hallucinations and/or delusions.

Anxiety disorder has the following manifestations:

• heavy, obsessive thoughts;
• sleep disorders;
• decreased appetite;
• constant feeling of anxiety or fear;
• dyspnea;
• tachycardia;
• deterioration in concentration.

Features of the course in children and adolescents

The clinical picture of affective disorders in children and adolescents has distinctive features. Somatic and vegetative symptoms come to the fore. Signs of depression are:

• night terrors, including fear of the dark;
• problems falling asleep;
• pale skin;
• complaints of chest or abdominal pain;
• increased fatigue;
• a sharp decrease in appetite;
• moodiness;
• refusal to play with peers;
• slowness;
• learning difficulties.

Manic states in children and adolescents also occur atypically. They are characterized by such signs as:

• increased cheerfulness;
• disinhibition;
• uncontrollability;
• sparkle of eyes;
• facial hyperemia;
• accelerated speech;
• constant laughter.

Diagnostics

Diagnosis of affective disorders is carried out by a psychiatrist. It begins with a thorough history taking. For an in-depth study of the characteristics of mental activity, a medical and psychological examination may be prescribed.

Affective symptoms can be observed against the background of diseases:

• endocrine system (adrenogenital syndrome, hypothyroidism, thyrotoxicosis);
• nervous system (epilepsy, multiple sclerosis, brain tumors);
• mental disorders (schizophrenia, personality disorders, dementia).

That is why the diagnosis of affective disorders must necessarily include an examination of the patient by a neurologist and endocrinologist.

Treatment

The modern approach to the treatment of affective disorders is based on the simultaneous use of psychotherapeutic techniques and antidepressant medications. The first results of the treatment become noticeable after 1-2 weeks from its start. The patient and his relatives should be informed about the inadmissibility of spontaneous discontinuation of medications, even in the case of persistent improvement in mental health. Antidepressants can be discontinued only gradually, under the supervision of the attending physician.

According to statistics, affective disorders of varying severity are observed in every fourth adult inhabitant of our planet. However, no more than 25% of patients receive specific treatment.

Prevention

Due to the unknown nature of the exact causes underlying the development of affective disorders, there are no specific preventive measures.

Consequences and complications

Affective disorders, especially in the absence of adequate therapy, worsen the patient’s socialization, interfere with the establishment of friendly and family relationships, and reduce ability to work. Such negative consequences worsen the quality of life not only of the patient himself, but also of his close circle.

Suicide attempts can be a complication of some mood disorders.

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The significant psychopathological polymorphism of these syndromes and the variability of their dynamics make attempts to create a typology of the phases of manic-depressive psychosis extremely difficult. The complexity of this problem is aggravated by the fact that until now there is no unified classification of affective syndromes.

By dividing affective syndromes into relatively simple and complex ones, highlighting a number of psychopathological variants in each of these groups, one can get the most complete picture of their diversity:
to relatively simple affective syndromes These include conditions whose manifestations do not go beyond the affective register - primarily classic circular depression and mania; Their characteristic feature is the harmonious expression of the affective triad of symptoms: with depression - depressed mood, motor and ideational inhibition, with mania - elevated mood, ideational and motor excitation
To psychopathologically complex include syndromes combining affective disorders with manifestations of other psychopathological registers

Circular (vital) depression

Classic circular (vital) depression is characterized by:
depressive delusional or overvalued ideas of self-blame and self-humiliation
manifestations of depressive anesthesia
suicidal thoughts and attempts
daily mood swings
somatovegetative manifestations (sleep disorders, appetite disorders, menstrual irregularities, constipation, etc.)

The group of simple depressions includes:
depression with delusions of self-blame
anesthetic depression
anxious depression
agitated depression
stuporous depression
dysphoric (grumpy) depression
tearful depression
smiling (ironic) depression
adynamic depression

Complex types of depression include:
depression with delusions of blame and condemnation
depression with delusional ideas close to paranoid (damage, everyday relationships, following, poisoning, etc.)
depression with Cotard's syndrome
depression with sensual delirium
depression with hallucinosis and manifestations of Kandinsky-Clerambault syndrome
depression, senestopathies, hypochondriacal delusions, obsessions
depression with psychasthenic manifestations, vegetative and somatic disorders

Circular mania

Circular manias, in addition to manifestations of the affective triad, are characterized by:
ideas of overvaluation or grandeur
disinhibition of drives
distractibility
sleep disorder
increased appetite, etc.

The most common variants of simple manic syndrome are:
unproductive mania
confused mania
angry mania

Complex variants of manic syndrome include:
mania with sensual delirium
mania with hallucinosis and phenomena of mental automatism
mania with senestopathies and hypochondriacal delirium

Manic-depressive psychosis

Affective insanity(circular disease, circular psychosis, cyclophrenia, cyclothymia) is a disease that occurs in the form of affective phases, separated by intermissions, which does not lead to a change in personality, to the formation of a defect, even over a long (many years) course with multiple relapses. The main manifestations of manic-depressive psychosis are depressive and manic phases of various structures.

Manic-depressive psychosis is more characterized by phases with relatively simple affective syndromes. At the same time, there is a significant diversity of affective manifestations, expressed in varying degrees of their severity and features of the psychopathological structure.

The phases of manic-depressive psychosis can be divided:
into typical ones, the picture of which is limited to affective manifestations
to atypical with the occurrence of:
- complex affective syndromes
- mixed states (combining manifestations of depression and mania in various ways)
- inharmonious development of the main components of affective states

Within the phases of manic-depressive psychosis, depressive and manic states undergo modifications in the structure and intensity of manifestations:
in the initial stages depression, somatovegetative disorders with a decrease in affective tone and asthenic disorders are observed. Sleep and appetite are disturbed, constipation appears. There is a feeling of compression, heaviness in the head, in the heart area, hyperesthesia, tearfulness, lethargy, “laziness,” and decreased performance. The depressive coloring of the state is manifested by a weakening of contacts, the ability to rejoice, and a tendency to pessimism. Identifying these symptoms in combination with their daily fluctuations makes it possible to recognize the cyclothymic phase and serves the purpose of early diagnosis of more severe depression.
at the next stage During the depressive phase, depression becomes more intense and manifests itself in the appearance, statements and behavior of patients. An affect of melancholy or vague anxiety, physical discomfort, stiffness of movement, and pessimistic self-esteem are noted. Depressive facial expressions, quiet, monotonous speech, somato-autonomic disorders intensify. Pale skin, weight loss, anorexia, constipation, and a coated tongue are noted. The assessment of the past, present and future is pessimistic. There are daily mood swings and ideas of inferiority.
when the phenomena deepen depression, all these symptoms reach particular severity (“classical melancholy”). At the height of development, depression can occur without daily fluctuations, which indicates its significant intensity. Often the extreme degrees of development of depressive phases are states of melancholic paraphrenia. Suicidal attempts are possible with depression of any severity. Most often they occur during periods of less pronounced motor retardation, i.e. in the initial or final stage of the phase.

Types of depressive phases:
cyclothymic depression - the clinical picture is limited to disorders characteristic of the initial stage
simple circular depression is the most common and typical variant of endogenous depression
delusional circular depression - a combination of severe depressive affect with depressive delusional ideas
melancholic paraphrenia

Degrees of severity of the manic phase:
mild - hypomania
pronounced - typical circular mania
severe - mania with delusions of grandeur, mania with confusion

In some manic phases, all stages of development from hypomania to severe manic states can be traced:
in the initial stages In such phases, there is an increase in physical and mental tone, a feeling of vigor, physical and mental well-being, good mood and optimism. The behavior of patients is characterized by liveliness. Self-esteem is increased. Patients do not feel tired, their appetite is increased, sleep duration is shortened, then all manifestations of mania become especially clinically distinct (simple mania)
at the next stage severe mania (psychotic mania) with a significantly elevated mood, a “jump of ideas” appears, sometimes reaching the point of confusion. Agitation may be accompanied by erratic aggression.
with further strengthening phenomena of mania, delusional ideas of grandeur appear, sometimes acquiring a fantastic character.

Symptoms of mania at almost all stages of phase development are more noticeable than symptoms of depression. At the same time, the uniqueness of the initial stage of mania, which creates the impression of complete well-being, makes it difficult for the patient and others to assess the hypomanic state.

Phases of manic-depressive psychosis can occur in the form of mixed states. More often, these states are observed not as independent phase states, but at the junction of depressive and manic states with a dual or continuum version of the course of manic-depressive psychosis. The typical typology of mixed conditions is extremely difficult.

Variants of the course of manic-depressive psychosis:
cyclothymic(outpatient) - observed in 70% of cases; with it, more severe phases at the psychotic level may occur; with this option, the most common flow is of the “cliché” type - with the same structure and duration of the phases; depressive phases predominate with a clear expression of all components of the depressive triad
cyclophrenic(occurring with the so-called psychotic phases) - a significant psychopathological variety of phases is observed - almost all types of simple and complex endogenous depressions and manias
atypical – in phases of manic-depressive psychosis, affective-delusional disorders may also be observed
continuous - continuous change of polar affective phases

The course of manic-depressive psychoses can be:
monopolar - in the form of phases of the same type
bipolar - depressive and manic phases are combined in different ways

Directive phases during manic-depressive psychoses can be strictly defined, i.e. end with intermissions. However, quite often a course is observed in the form of “double”, “triple” phases, when depressive and manic states replace each other without clear intervals.

Average duration of phases Manic-depressive psychosis lasts several months, and depressive phases are usually longer than manic phases. Phases, especially depressive ones, lasting more than a year, sometimes several years, are not uncommon. Chronic phases of the disease are possible, in most cases depressive. The onset of chronic depression can occur after phases of normal duration.

Duration of intermissions is also extremely variable. There may be cases of the disease with the first phase - at a young age and a second phase - during the period of involution. Frequent recurrence of the disease is possible, especially in the later stages. Phases of manic-depressive psychoses, especially in the initial stages of the disease, can be provoked by exogenous factors. However, more typical for manic-depressive psychoses is the autochthonous occurrence of phase states. Less typical, although possible, is the provocability of all or most of the phases during manic-depressive psychoses. One of the features of the course of manic-depressive psychoses is the seasonal preference for the occurrence of affective phases. Although this property is not exclusive to manic-depressive psychoses, it is quite often observed in the paroxysmal course of schizophrenia.

More typical for manic-depressive psychosis is debut of the disease in the form of depressive phases. The onset of the disease with manic states often indicates a less favorable prognosis. Quite often, with the manic debut of the disease in further affective phases, signs of atypia appear in the form of interpretive or sensory delusions, hallucinatory disorders, manifestations of Kandinsky syndrome - in such cases we can talk about affective-delusional attacks of schizophrenia. At the stage of development of atypical affective states, it is usually possible to detect certain negative signs. The debut of manic-depressive psychosis in the form of mania is often a sign indicating the possibility of the emergence of dual or combined affective phases in the subsequent course or a transition to a continuum course. Continua course clearly correlates with a poorer prognosis- the possibility of personal changes and complication of affective states due to various kinds of “additional” symptoms, i.e. gives reason to suspect quite early the procedural nature of the disease.

These syndromes include depressive and manic, which are characterized by a triad consisting of mood disorders, motor disorders and changes in the course of associative processes.

However, this triad does not exhaust the clinical picture of both depressive and manic states. Characterized by disturbances in attention, sleep, and appetite. Autonomic disorders are most typical of emotional endogenous disorders and are characterized by signs of increased tone of the sympathetic division of the autonomic nervous system.

Depressive syndrome

Typical depressive syndrome. Depressive syndrome is characterized by a depressive triad: hypothymia (depressed, sad, melancholy mood), slowed thinking and motor retardation. The severity of these disorders varies. The range of hypothymic disorders is large - from mild depression, sadness, depression to deep melancholy, in which patients experience heaviness in the chest, chest pain, hopelessness, and worthlessness of existence. Everything is perceived in gloomy colors - the present, the future and the past. In some cases, melancholy is perceived not only as mental pain, but also as a painful physical sensation in the area of ​​the heart, in the chest, “precordial melancholy.”

A slowdown in the associative process manifests itself in impoverishment of thinking: there are few thoughts, they flow slowly, chained to unpleasant events, illness, and ideas of self-blame. No pleasant events can change the direction of these thoughts. The answers are monosyllabic, after a long pause.

Motor retardation manifests itself in slower movements and speech: speech is quiet, slow, mournful facial expressions, movements are slow, monotonous, patients can remain in one position for a long time. In some cases, inhibition reaches complete immobility - depressive stupor.

Sometimes motor retardation is suddenly replaced by an attack of excitement, an explosion of melancholy (melancholic raptus - raptus melancholicus). The patient suddenly jumps up, hits his head against the wall, scratches his face, can tear out an eye, tear his mouth, injure himself on some object, break glass with his head, jump out of the window, while the patient screams and howls heart-rendingly. The patient manages to be restrained and goes to bed, but he again experiences motor retardation.

With depression, daily mood fluctuations, characteristic of endogenous depression, are often observed. In the early morning hours, there is an increase in melancholy and suicidal thoughts; it is during these hours that patients are most dangerous for themselves due to the possibility of committing suicide.

Depressive syndrome is characterized by ideas of self-blame, sinfulness, and guilt, which can also lead to thoughts of suicide.

Depressive syndrome is usually accompanied by autonomic disorders: tachycardia, blood pressure fluctuations with a tendency to hypertension, loss of appetite, constipation, weight loss, endocrine disorders.

Depending on the predominance of various components in the structure of depression, melancholy, anxious, apathetic depression and other variants of depressive states are distinguished.

For sad depression All the symptoms of the depressive triad are most pronounced: sad mood, slow thinking and motor retardation.

Anxious depression characterized by a painful, painful expectation of inevitable misfortune and is accompanied by monotonous speech and motor agitation. Patients are convinced that something irreparable is about to happen, for which they are to blame. In some cases, motor excitation reaches a frenzy, patients rush about, moan, shout out individual words, and injure themselves. This condition is called agitated depression.

For apathetic, or adynamic, depression characterized by a weakening of all impulses. Patients are lethargic, indifferent to their surroundings, indifferent to their condition and the situation of their relatives, reluctant to make contact, do not express any specific complaints, and often say that their only desire is not to be touched.

For masked depression characterized by the predominance of various motor, sensory and autonomic disorders. The clinical manifestations of this depression are extremely varied. Various complaints of disorders of the cardiovascular system and digestive organs are common. There are attacks of pain in the heart, stomach, and intestines. These disorders are accompanied by sleep and appetite disturbances. Depressive disorders are not clear enough and are masked by somatic complaints.

With masked depression, the patient is treated for a long time and persistently by doctors of various specialties to no avail; when using various research methods, a specific somatic disease is not detected; Despite failures in treatment, patients stubbornly continue to visit doctors. With masked depression, attention is drawn to daily fluctuations in somatic complaints and asthenia, characteristic of depression.

Depressive equivalents- periodically occurring conditions characterized by various complaints and symptoms of a predominantly vegetative nature, sometimes replacing attacks of depression in manic-depressive psychosis (affective psychoses).

Manic syndrome

Affective syndromes have the form of negative emotional disorders, namely mania and depressive states. Affective syndrome of a depressive nature differs from others by the presence of an ongoing bad mood, sadness and melancholy.

These symptoms can be supplemented by bodily symptoms in the form of physical discomfort, which manifests itself in the form of heaviness in the chest and difficulty breathing - a feeling of insufficient inhalation. In addition to the above symptoms, inhibition of reactions and movements, suppression of interest in previously favorite things and a slowdown in the mental activity of the brain are detected.

Depressive states with affective syndrome they have a different nature and are divided into the following: depression of a psychogenic nature, endogenous depressive states,manic-depressive psychoses , symptomatic depression.

Anxiety and low self-esteem of a patient with a depressive state of affective syndrome are characterized by a gloomy perception of the surrounding reality. This condition is characterized by a change in the manifestation of activity during the day. The patient feels worst in the morning, since at this time the depressive state manifests itself most strongly, and by the end of the day the condition stabilizes a little. In this case, the patient experiences sleep disturbances, loss of appetite and weight loss.

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Affective syndromes - types and manifestations

Agitated depressive state

An agitated depressive state manifests itself in the form of constant mental anxiety and impaired efficiency of motor activity. Patients cannot stand still and constantly make strange sounds. This depression is adynamic in nature, that is, there is inhibition of movement, speech and lack of initiative.

Hypochondriacal depression (hypochondria)

Hypochondriacal depression manifests itself in the form of excessive anxiety of the patient about the danger of his situation, for example, the danger of a completely harmless disease. Anxiety arises even if the illness from the disease does not cause much discomfort or the disease is habitual.

Asthenic depression

Asthenic depression is characterized by the presence of constant lethargy in the body, severe physical and mental fatigue, impaired concentration and increased irritability. Also, along with the above symptoms, melancholy, lethargy and depression of mental activity appear.

Hysterical depression

With depression of a hysterical nature, hysterical states appear, namely despair, accompanied by causeless sobs, convulsions, tremors, memory disorders, hallucinations. Patients with this type of depression are often prone tosuicidal behavior .

Manic affective syndromes

Affective syndromes of the manic variety are characterized by an uncharacteristically elevated mood, which, in turn, is accompanied by inexplicable optimism. With this syndrome, accelerated mental activity and excessive activity in body movements are observed.

Mania develops due to the presence of diseases of the central nervous system. Patients show unusual joy, feel happiness and a certain groundless “high” from their life, often overestimating their capabilities and strengths, which can lead, for example, tomegalomania . The high speed of updating thoughts and ideas is accompanied by severe distractibility. There is a high level of speech activity and a great desire to expand one’s activities, no matter the cost.

Patients with mania negatively accept any criticism and react to it aggressively. Patients often act thoughtlessly and senselessly. Against the background of general excitability, sleep disturbances, increased appetite, and sudden weight loss are possible.

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Affective insanity - a severe mental illness that occurs with alternating changes in manic and depressive phases, between which there is a period of mental stability - the so-called “bright interval”.

Affective syndromes are symptom complexes of mental disorders, defined by mood disorders.

Affective syndromes are divided into two main groups - with a predominance of high (manic) and low (depressive) mood. Patients with are found many times more often than with, and special attention should be paid to them, since approximately 50% of people who attempt suicide suffer from depression.

Affective syndromes are observed in all mental illnesses. In some cases they are the only manifestations of the disease (circular psychosis), in others - its initial manifestations (brain tumors, vascular psychoses). The latter circumstance, as well as the very high frequency of suicides among patients with depressive syndromes, determines the tactics of behavior of medical workers. These patients should be under strict medical supervision around the clock and should be referred to a psychiatrist as soon as possible. It must be remembered that not only rude, but simply careless treatment of manic patients always leads to increased agitation in them. On the contrary, attention and sympathy for them allow, even for a short time, to achieve their relative calm, which is very important when transporting these patients.

Affective syndromes are syndromes in the clinical picture of which the leading place is occupied by disturbances in the emotional sphere - from mood swings to expressed mood disorders (affects). By nature, affects are divided into sthenic, occurring with a predominance of excitement (joy, delight), and asthenic, with a predominance of inhibition (fear, melancholy, sadness, despair). Affective syndromes include dysphoria, euphoria, depression, and mania.

Dysphoria- a mood disorder characterized by a tense, angry-sad affect with severe irritability, leading to outbursts of anger and aggressiveness. Dysphoria is most common in epilepsy; with this disease they begin suddenly, without any external reason, last for several days and also end suddenly. Dysphoria is also observed in organic diseases of the central nervous system, in psychopaths of the excitable type. Sometimes dysphoria is combined with binge drinking.

Euphoria- elevated mood with a hint of contentment, carelessness, serenity, without accelerating associative processes and increasing productivity. Signs of passivity and inactivity predominate. Euphoria occurs in the clinic of progressive paralysis, atherosclerosis, and brain injury.

Pathological affect- a short-term psychotic state that occurs in connection with mental trauma in persons who do not suffer from mental illness, but are characterized by mood instability and asthenia. The intensity of affect, anger and rage in this state are immeasurably greater than those characteristic of physiological affects.

The dynamics of pathological affect are characterized by three phases: a) asthenic affect of resentment, fear, which is accompanied by disturbances in thinking (incompleteness of individual thoughts, their slight incoherence) and autonomic disorders (pallor of the face, trembling hands, dry mouth, decreased muscle tone); b) affect becomes sthenic, rage and anger predominate; consciousness sharply narrows, mental trauma dominates in its content; disorders of consciousness deepen, accompanied by agitation and aggression; the nature of vegetative changes becomes different: the face turns red, the pulse quickens, muscle tone increases; c) recovery from pathological affect, which is realized by prostration or sleep, followed by complete or partial amnesia.

Treatment of affective states. The presence of one or another affective syndrome in patients requires the doctor to take emergency measures: establishing supervision over the patient, referring him to a psychiatrist. Depressed patients who may attempt suicide are admitted to a unit with enhanced supervision. They must be transported to the hospital under the close supervision of medical staff. On an outpatient basis (before hospitalization), patients in a state of agitated depression or depression with persistent suicidal attempts are prescribed an injection of 5 ml of a 2.5% solution of chlorpromazine.

When prescribing therapy, the nosological diagnosis and characteristics of the patient’s condition are taken into account. If depression is a phase of circular psychosis, then treatment is carried out with psychotropic drugs - antidepressants. If there is agitation and anxiety in the structure of this depression, combination therapy with antidepressants (in the first half of the day) and antipsychotic drugs (in the afternoon) is prescribed, or treatment is carried out with nosinane, amitriptyline.

For psychogenic depression, if it is not deep, hospitalization is not necessary, since its course is regressive. Treatment is carried out with sedatives and antidepressants.

Patients in a manic state are usually hospitalized, since it is necessary to protect both those around them and the patients themselves from their incorrect and often unethical actions. To treat manic states, neuroleptic drugs are used - aminazine, propazine, etc. Patients with euphoria are subject to hospitalization, since this condition indicates either intoxication (which requires quick recognition to take emergency measures), or an organic brain disease, the essence of which must be clarified . The euphoria of convalescents who have suffered an infectious or general somatic disease at home or in a somatic (infectious diseases) hospital is not an indication for hospitalization in a psychiatric hospital. Such patients should be under constant supervision of a doctor and staff. For their treatment, along with general restoratives, sedatives can be used. Patients in a state of epileptic dysphoria are also hospitalized due to the possibility of aggression.