Sloppiness and selfishness as a mental deviation. Negligence and slovenliness matter in diagnosis

Unfortunately, many people consider it normal when the kitchen sink is littered with dirty dishes, when clothes are scattered all over the room, when before leaving the house you have to look for lipstick or clean socks for hours ... Sloppiness is justified by lack of time, but this is just an excuse that has nothing to do with reality.

So what is slovenliness?

According to German experts, slovenliness can rightfully be considered a disease.
A symptom of slovenliness is a dirty apartment, littered with a pile of unnecessary things.

Many of us may call this just a habit, but according to scientists, it is a mental illness. There is even the term "messy syndrome", which in translation from English (messy) means "messy, dirty".

According to experts, about 2.5% of the total population, that is, approximately 2 million people, suffer from this disease in Germany.

Doctor of Medicine von Wedigo claims that the patient's condition may worsen over time if one fails to overcome oneself in time. Over time, the house really turns into a "garbage heap", where there is no longer room for a full life.

And no matter how much a person puts on the most fashionable clothes, how much he pours expensive perfume on himself, hangs himself with expensive branded jewelry, all the same - if the hand does not go to throw away the tights that were worn to holes 5 years ago, then the slovenliness syndrome is obvious ...

According to doctors, it is impossible to get rid of this syndrome completely, but it is possible to help a person bring his life back to normal. By the way, in Germany there are already social workers whose task is to regularly visit such patients and assist them in cleaning up the "rubble" of things.

There is also another syndrome, which consists in cluttering up your home. It is called the Diogenes syndrome.

During this disorder, people bring into the house and keep a lot of unnecessary things. In Soviet times, in conditions of total shortages, there was still some justification for such behavior, but many still retain their old habits.

The main task is to realize the pathological nature of such habits, gather courage and decisively get rid of all the rubbish that does not allow you to breathe and move freely in your own home. And according to the rules of Feng Shui, such blockages impede success and create health and financial problems.

If you need changes in your life, if you are striving for something new and progressive, for joy and prosperity, first clear a place for this, get rid of the old ballast of unnecessary things so that the new has somewhere to come.

As a rule, this deviation is observed in adulthood and is characterized by a desire for isolation from others.

The disease got its name from the ancient Greek philosopher Diogenes, who preaches the principle of contentment with little. According to the facts, the thinker lived in a barrel, ate leftovers and was famous for his provocative actions. People suffering from this syndrome are so prone to slovenliness that their lifestyle brings a lot of discomfort to both family members and neighbors. According to the facts, the disorder is diagnosed in 3% of the elderly.

Features of the disease, its symptoms and causes

For the first time, the disease began to be considered as a separate psychopathological syndrome back in 1966. The name "Diogenes syndrome" was proposed by British scientists in 1975. To date, there are ongoing discussions about the correctness of just such a name for the disease, many psychiatrists consider the terms “syllogomania” or “senile squalor syndrome” to be the most suitable for use. The fact is that the fundamental symptom of this mental disorder is the pathological accumulation of unnecessary things.

The ancient Greek philosopher, after whom the disease got its name, did not suffer from collecting unusable objects. He lived in poverty and the only object of his possession was a cup, which, in the end, the thinker broke due to the philosophical ideas of asceticism.

In domestic psychiatry, another name for this psychopathology is widely used - "Plyushkin's syndrome". As you know, this character of Gogol's great poem was famous for his stinginess and craving for the accumulation of unnecessary things with which he completely filled up his home.

Among the main symptoms of the disease are:

• pathological hoarding;
• aggressiveness and negativism towards persons who criticize the patient;
• lack of self-criticism of one's condition;
• non-observance of hygiene rules, carelessness;
• avarice;
• isolation from the public;
• apathy, indifference;
• lack of shame;
• self-disdain.

Collecting unusable things sometimes clutters up the home of pathological misers so much that it literally turns into a garbage dump. Hoarders carry various unnecessary items to themselves, which, in their opinion, may come in handy sooner or later. The place of residence of the drive is sometimes so crowded with all sorts of rubbish that it becomes even difficult to move around the house. People suffering from this syndrome drag everything from the street: from old, broken furniture to empty cardboard boxes, some even managed to store rotten vegetables and fruits. An unpleasant smell emanates from all this rubbish, cockroaches and rats often start up in the room. The greatest discomfort is received by family members and neighbors living next to the pathological drive.

As a rule, any criticism of the patient is not perceived, and any offered help is immediately rejected. Pathological "Diogenes" after several complaints about their lifestyle become suspicious, taciturn and secretive. Sometimes it is simply impossible to establish contact with them, relatives have to resort to forcible hospitalization of the patient (in extremely difficult conditions).

Patients do not realize the seriousness of their condition, they answer many claims that this is their lifestyle, a hobby. According to the accumulator, any thing can be used: “old boards can be used to build a barn,” and “you can store something in empty tea boxes.” Guided by this principle, a person turns his life into an obsessive search for unusable objects.

The appearance of such people is untidy, often they do not care about how they look. The neglect of hygiene makes them look like homeless vagrants. In matters of nutrition, syllologomaniacs are also not picky, as a rule, they save on food. There are many cases when patients ate leftovers from garbage dumps simply because they did not want to spend extra money on food. Essentials and medicines, according to pathological drives, are also not very important. Many patients do not leave the house for months, considering communication with people useless and boring. Neglect of one's health and social isolation sometimes leads to sad consequences. The facts are that some recluses die all alone, surrounded by garbage barricades.

Another sign of disorder is a lack of shame. Syllogomaniacs can publicly defecate, change clothes or even undress. They are driven by indifference to what others think, actions take place on the principle of "I want and I do." Quite often, patients end up in the police department because of their shameless behavior and violation of the rules of order.

An interesting fact is that often people suffering from syllogomania are the owners of large savings, although they live like beggars. There are many cases when the former rich and influential personalities became vagabonds, coming home only to bring another rubbish. So, one American millionaire was so stingy that at the age of forty he simply decided to live in a landfill in order to spend less money.

Among the causes of the disease are:

• organic lesions of the frontal lobes of the brain;
• mental disorders of old age;
• alcoholism;
• pathological tendency to collect.

According to psychophysiological studies, the disease can occur as a result of damage to the frontal lobes of the brain. The cause of such lesions can be injuries, brain diseases, unsuccessful operations. These areas of the cortex are responsible for decision-making, and it is their damage that leads to the development of a pathological craving for accumulation.

Sometimes syllogomania is only part of a serious mental illness. Most often, the syndrome occurs in obsessive-compulsive disorder, senile dementia, and Pick's disease.

How to treat Diogenes syndrome

Therapy of the disease should be carried out without fail, since its symptoms can sometimes signal the development of a more serious psychopathology.

So, how to treat Diogenes syndrome? As pharmacotherapy, sedatives, antidepressants, antipsychotics are widely used. Central to the diagnosis of the syndrome is the conduct of computed tomography of the brain, to determine the degree of damage to brain areas. Psychotherapy, as a rule, is not used, since the basis of the disease lies in the organic lesion.

The main point in the treatment of the disease is family support and care. Often, lonely people, deprived of family love and mutual understanding, suffer from Diogenes syndrome.

Sloppiness as a symptom of illness

Neglect of hygiene, or slovenliness, is a common occurrence in everyday life. The reason for the lack of cleanliness in clothes and at home can be a lack of time, the costs of education, material difficulties or banal laziness. But all of these problems concern people who are mentally healthy. Total disregard for hygiene rules is often a symptom of mental illness when it comes to people suffering from nervous disorders.

Sloppiness is a symptom of a disease affecting the mental sphere

Any chronically current or acute mental illness has its own symptoms, according to which it is diagnosed. Untidiness can be detected with such nervous disorders:

If a person suddenly begins to neglect personal hygiene, show slovenliness in clothes, this should alert his loved ones. The sudden appearance of untidiness is a symptom of changes in the emotional-volitional sphere and can accompany many pathological processes in the psyche.

With senile dementia, such a symptom as untidiness is not always present. Patients can maintain independence, accuracy and pedantry for a long time. If progressive dementia is accompanied by exhaustion of the nervous system, depressive manifestations, psychotic disorders, then slovenliness is a symptom of the disease, and it can be considered as the first manifestation of dementia. Such a development of the disease is characteristic mainly for dementias of the vascular and mixed type.

Sloppiness: causes

With dementia, the appearance of untidiness is associated with likening a small child who is unable to control himself, evaluate, or be responsible for his actions. He needs outside control and care. Dementia in the elderly is associated with age-related changes that occur gradually. In this case, custody of the patient may be late. Sometimes they begin to take care of a sick person only after the transition of the disease to a serious stage, which makes the implementation of hygiene procedures on their own an impossible task.

Drug addiction and alcoholism inevitably lead to personality degradation, antisocial behavior. A person who has isolated himself from society does not feel the need to maintain his appearance in proper order. Untidiness in clothes, slovenliness in the language are alarming symptoms that signal problems in the mental state of a person. If you witness such changes in the appearance of your relative or colleague, make every effort to eliminate them. It is important to remember that sloppiness is only a consequence of the deformation of the psyche. To eliminate the cause of the disease, you should immediately contact a psychiatrist.

Practice shows: such a symptom as slovenliness can have a variety of causes. An early reaction to such body signals gives more chances to stop the disease, preventing it from moving into a hopelessly difficult stage. Specialists of the Mental Health Clinic diagnose the disease, rationally select treatment based on the characteristics of age criteria.

Sloppy sign

What is behind the term "slovenliness", many know. This is a neglect of the order in the human environment and / or a violation of the norms of body hygiene. The indifferent attitude of a person to his own appearance causes, at a minimum, bewilderment, and sometimes just a feeling of disgust among others. The messy, cluttered environment that surrounds a person can suggest a catastrophic lack of time, carelessness to things, or a simple unwillingness to spend time cleaning.

Usually signs of slovenliness are attributed to cases of lack of education in childhood, unaccustomed to order, laziness or lack of aesthetic taste. But slovenliness can also act as a symptom of a mental disorder. And if in case of slovenliness, fixed in the form of a character trait, a person can be influenced by persuasion, by his own examples, to impose on him an algorithm, under which he will be able to achieve certain success in changing his cluttered world and appearance, then in the case of a mental disorder, cope with the phenomenon slovenliness is very hard. Mental disorder and self-esteem are often incompatible things, therefore it is not possible to convince a person to look at himself from the outside and evaluate his appearance or the condition of his housing (workplace).

As a rule, such painful phenomena of slovenliness occur during puberty of adolescents, when some biochemical processes in the body change, which can affect the functioning of the brain. Most often, after leaving the puberty period, the phenomena of slovenliness gradually disappear. But this does not always happen, because a careless attitude towards one's body and a slovenly attitude towards things can be learned from childhood as a result of imitating one or both parents, regardless of the educational process carried out by them with the child.

A person is somewhat different from an animal in terms of instincts, and if in animals the need for the cleanliness of their own body is associated with the instinct of self-preservation, then in a person the love of cleanliness is fixed in the form of a habit (developed independently or copied in childhood from the behavior of the people around him, in particular, with parental behavior).

A careless attitude towards oneself and the environment can be the result of depression, when a person who is always neat and collected in everyday life, loving order, cleanliness and tidiness, gradually begins to slide into the abyss of indifference and chaos, ceases to notice the inconveniences and clutter surrounding him, begins to neglect partially or completely own hygiene. Upon getting out of depression, such a person will pull himself together and begin to observe, as before, his own rules of hyena and order, but in the case of untreated depression and the inability to get out of it on his own, slovenliness can take on catastrophic proportions.

Sloppiness can be a sign of personality degradation in certain diseases: alcoholism, drug addiction.

Frequent cases of slovenliness are observed in older people during the degradation of brain cells. Such people require the attentive attitude of relatives and the help of a psychiatrist who will select the optimal treatment for each specific case. It will not be possible to cope on your own or with the help of relatives who do not have experience in such a matter.

There is a kind of slovenliness associated with an irresistible desire to accumulate things, as a result of which housing turns into a cluttered warehouse or garbage dump. Foreign scientists have coined a term for this state of slovenliness: "Messy Syndrome" (messy - translated from English dirty, messy). This condition has other names in the medical literature: Diogenes Syndrome, Plyushkin Syndrome, Syllogomania. As it turned out, this condition can be caused not only by diseases that affect brain cells, but also by deep psychological trauma (loss of a loved one, destroyed personal life). In the case of the Messi Syndrome, the help of a psychiatrist is required.

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ATTENTION! The information posted on the site is intended to expand the horizons in the field of medicine and related sciences. All described methods of treatment are of a general nature and cannot be used without individual correction by a doctor based on laboratory and hardware diagnostics. DO NOT self-medicate! DO NOT experiment with your health!

Ignorance is a disease

German scientists are sure: slovenliness is a mental illness. They even came up with a special term for him - "Messi syndrome" (from the English word messy - dirty, messy).

According to experts, in Germany alone, 2 million people suffer from this disease. They include those who live in a dirty apartment, in addition, littered with piles of unnecessary things. Dr. Wedigo von Wedel, MD, believes that such a disorder is clearly underestimated, because pathological gathering, one of the main components of the syndrome, prevents people from leading a normal life. For others, the disease develops imperceptibly: things from the garbage begin to appear in the house, and all attempts to throw out the trash end in tantrums of the owners of "wealth". At the same time, neither age, nor social status, nor gender of modern plushkins play a role. Doctors call a possible cause of Messi syndrome a severe psychological trauma, for example, the loss of a loved one.

Alexander MAGALIF, senior researcher at the Moscow Research Institute of Psychiatry, leading specialist of the Psychological Adaptation Clinic:

– A person who lives in a dirty and cluttered dwelling is not necessarily a pathological collector, much less mentally ill. People are sluts from childhood and remain so all their lives. Sloppiness is a trait of their character and even a family "tradition". The condition described by German scientists is indeed a symptom of a mental disorder, when a patient with an emotional and volitional defect does not wash for weeks or even months, digs in garbage cans, drags all sorts of rubbish into the house, etc. But this is not an independent disease, but one of the manifestations of a more complex mental pathology. Often this is observed in old people with age-related decline in intelligence. They walk down the street with bundles full of "valuable" things. Such behavior can indeed occur after mental trauma, but it is a manifestation of a protracted reactive state and changes in lifestyle, including the system of values ​​and priorities.

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I am a slob: causes and how to fix?

Negligence and slovenliness can be a characterological trait of a person that is formed during the period of a person’s upbringing and this quality can be modeled from adults, even despite all the efforts of parents to accustom a child to order.

If one of the parents is careless or sloppy, and the other, on the contrary, is neat, then the probability of the acquired character trait by the child will be about 50% of the probability. Since the upbringing of a child does not take place on the basis of moral teachings, by example. The child will imitate the parent who is more authoritative for him in the family.

Is slovenliness a disease?

Have you noticed that sluts are always and everywhere late. They forget important assignments, never get enough sleep, miss important meetings.

Chaos reigns not only in their apartments and desktops. Chaos reigns in their heads.

Sloppiness is a sign of depression, attention deficit disorder, and even some neuropsychiatric diseases.

If sloppiness is a sign of a disease, then you should immediately consult a doctor.

If this is a sign of disorganization, you can self-medicate.

Causes

1. You were simply not taught to keep the house in order. This is not psychology, but quite a household skill that parents had to instill in science to their children. Most likely, in most of our families, cleaning was carried out according to the “hands-on” method, that is, “Guests are coming!”, “I will finally throw this rubbish away!” or "Aren't you ashamed to be overgrown with mud?!" This is a destructive presentation of putting things in order, and only a few know about the existence of a technique of order and cleanliness. And even fewer are able to methodically pass this technique on to their descendants.

2. Emotional immaturity. This is closer to psychological problems. Many people know what is needed for full physical development. These are nutrition, sports, sun and other physical factors. What does it take for a child to develop emotionally? The question is harder! In the meantime, from early childhood, the child must be taught to think that he is a full-fledged member of society, who is able to take care of himself and others. In practice, however, often everyday duties, such as washing dishes, for example, are used for the purpose of punishment, which forms a negative attitude towards work. Or, on the contrary, the child is protected from any household duties in favor of studying or, even worse, entertainment: "He will still have time to work out." This is a sure way to raise an overgrown child who, at any opportunity, will shirk from work.

3. Attention to one's person is the first full-fledged sign of psychological inferiority! Or another childish way of manipulation. “I can’t put on socks!”, “I can’t warm up dinner!”, “I can’t find mittens!” - “Oh, you are mine, good - let me put it on, warm it up, find it!”. And in adulthood, this goes on a large scale: money is lost, bills are not paid, the soup on the stove turns sour. In general, in any way you need to show that I am helpless, and therefore I need a “nanny” who will clean, find, serve for me.

4. Protest is another “hello” from childhood. Destructive ways of accustoming to order, in which rigidity, inconsistency or aggression prevailed, can result in teenage rebellion. Often this rebellion migrates into adulthood under the slogan: "I'm already an adult, I live as I want." And “I want” in defiance of the parent, that is, in disarray. Thus, a person of such a warehouse with his chaos continues to prove that he has the right to disobey his parents. Of course, there is also emotional immaturity involved here.

5. A family stereotype can also prevent a person from sorting out his home. If people lived in disorder from generation to generation, while maintaining a favorable emotional climate, a person needs the same mess to feel at home.

6. Lack of possessions (toys, clothes, books) in childhood contributes to hoarding in adulthood. A person experiences a subconscious fear of returning to a state of lack of everything again, therefore he does not part with the accumulated, although unnecessary.

7. Attachment to the past also prevents a person from parting with the rubble in the house. Every thing in their life is like a good friend that hurts to part with. Afraid of losing touch with the past, such people often experience fear of the future.

8. Aversion to housing blocks all attempts to start a clean life. Often the condition of a rented apartment or the life of a spouse’s parents is very depressing. No wonder, few people want to invest in someone else's property or adapt to the old man's customs.

9. If you have not been taught to respect yourself - this is another way not only to trash, but also to slovenliness in appearance. The main argument of a person who does not respect himself: “Yes, it will do for me!” If you use this phrase at least occasionally, you should probably learn a little more about self-esteem, then order will come to the house faster.

10. Emotional experiences do not allow a person to live in cleanliness and comfort. “I throw things around like I'm under hypnosis,” admits 30-year-old Anya. "I don't understand how this works!" In a state of emotional crisis, a person experiences a shift in priorities. Negative thoughts and feelings should have their place - like any object in the house - used, and then removed from sight. If you forgot to remove it or didn’t want to, then both negative experiences and clutter in the house begin to fill our lives. Thus, when we stop “cleaning up the head” - we stop cleaning up the house.

11. Depression is already a disease characterized by a decrease in mental and physical activity. With depression, a person loses motivation, which leads to clutter at home, and clutter at home, in turn, plunges into depression even more.

12. Mental problems are a frequent companion of a neglected home. For example, the so-called "Plyushkin's syndrome" is considered incurable. A person drags, mainly, all rubbish from the garbage heap, up to the complete filling of his housing. This is the most extreme and perhaps hopeless case.

How to fix?

1. Systematization. If you don’t know where to go from the amount of things, urgently come up with a system for storing them. Learn to arrange things in a certain order on shelves, boxes, boxes, etc. The principle is simple: like with like. Handles with handles, socks with socks.

2. No need to clear up rubble. If everything is running, then you can spend the whole weekend on such work. Start small. Today you lay out your clothes, tomorrow you review your papers, the day after tomorrow you arrange your books, and so on. Write a plan for yourself and act strictly according to the schedule. The main thing is to continue to follow certain principles and put things together correctly.

3. Convenient arrangement of furniture. You may be piling up your clothes because the closet is awkward.

Or the bedside table is impossible to reach. Arrange the furniture so that it is always convenient for you to use it.

4. Get rid of unnecessary. Give old clothes, books and magazines to those in need.

Take out old postcards, souvenirs and soft toys without regret.

Be sure to throw away expired cosmetics.

Women: if the husband is a slut

If a lady can be somehow shamed, like: “You're a woman!”, then it is much more difficult to reach a man. To begin with, most men believe that a woman MUST clean up their dirty socks, close the pasta, wash the plates, take out the beer bottles. It's very difficult to deal with this. If he was taught such behavior from childhood, he will live with such confidence all his life. You can, of course, put smelly socks thrown right next to your bathrobe on his pillow at night. But I'm afraid it won't do any good. Such a man is sure that he is a king and God, and a woman should serve him, and also give thanks for it.

1. First, of course, to talk from the very beginning of life together. It is clear that for all the time it is impossible to clearly distribute responsibilities such as: you walk the dogs, and I wash the dishes. What to do if he has an emergency at work, and he will only come after midnight? Wait until the animals at home are finished?

To talk - it means not to shout, not to start to stand up in a pose and set conditions. Just make it clear that one (one - if a sloppy woman) simply can not cope. And you don't want to live in mud.

Does not help? Let's move on to combat.

2. He left a dirty mug from under the compote on the table - pour it there for nice tea, or kefir, depending on what he asks. It's the same with plates.

3. Scattered things all over the room - put them in a neat pile in the middle of the room. May you enjoy it in the morning!

4. If you can't find paired socks before washing - buy multi-colored ones, for example, beige and gray pairs. Again "does not converge"? So give him different ones, one of this color, the other of this. “Sorry, honey, I don’t know on which chandelier and behind which cabinet their couple!”

For winter, you can buy red and green. Before going on a visit, give a pair of red + green.

5. I didn’t even bother to ask in the evening to iron my shirt in the morning - the flag in my hands, walk in mint. I'm not going to be late for work because of your carelessness.

6. There is a wrench on the kitchen table - put your thong on the dashboard in the car.

Serious note: do not take all the tips literally, they are not suitable for everyone. With such methods, you can correct a slut who sincerely strives for correction, simply because of his upbringing, he does not notice his “jambs” behind him.

And most importantly, you need to remember that any disorder in everyday life leads to disorder in the head. In addition, searching for the right things among the rubble takes a lot of time.

Therefore, being a slob in our time is an unaffordable luxury!

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Self Improvement and Self Development © 2018. All rights reserved.

• Are dementia and dementia the same thing? How does dementia progress in children? What is the difference between childhood dementia and oligophrenia
• Unexpectedly appeared untidiness - is this the first sign of senile dementia? Are symptoms such as untidiness and slovenliness always present?
• What is mixed dementia? Does it always lead to disability? How is mixed dementia treated?
• Among my relatives there were patients with senile dementia. What is my chance of developing a mental disorder? What is the prevention of senile dementia? Are there any medicines that can prevent the disease?

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is dementia syndrome?

The clinical picture of dementia depends on the cause that caused the organic brain damage, on the location and extent of the defect, as well as on the initial state of the body.

However, all cases of dementia are characterized by pronounced persistent disorders of higher intellectual activity (memory impairment, reduced ability for abstract thinking, creativity and learning), as well as more or less pronounced disturbances in the emotional-volitional sphere, from the accentuation of character traits (the so-called "cartooning") until the complete collapse of the personality.

Causes and types of dementia

First of all, specific types of dementia should be distinguished, in which the destruction of the cerebral cortex is an independent and leading pathogenetic mechanism of the disease:

• Alzheimer's disease;
• dementia with Lewy bodies;
• Pick's disease, etc.

The most common cause of secondary organic brain damage is vascular disorders, in particular atherosclerosis of cerebral vessels and hypertension.

Common causes of dementia also include alcoholism, tumors of the central nervous system, and traumatic brain injury.

Less often, infections become the cause of dementia - AIDS, viral encephalitis, neurosyphilis, chronic meningitis, etc.

In addition, dementia can develop:

• as a complication of hemodialysis;
• as a complication of severe renal and hepatic insufficiency;
• with some endocrine pathologies (thyroid disease, Cushing's syndrome, pathology of the parathyroid glands);
• in severe autoimmune diseases (systemic lupus erythematosus, multiple sclerosis).

Functional-anatomical types of dementia

Forms of dementia

Lacunar

However, a critical attitude to one's condition remains, and the emotional-volitional sphere suffers slightly (most often only asthenic symptoms are expressed - emotional lability, tearfulness, hypersensitivity).

A typical example of lacunar dementia is the initial stages of the most common form of dementia, Alzheimer's disease.

Total

The morphological substrate of total dementia is damage to the frontal lobes of the cerebral cortex, which often occurs with vascular disorders, atrophic (Pick's disease) and volumetric processes of the corresponding localization (tumors, hematomas, abscesses).

The main classification of presenile and senile dementias

There are three types of dementia most common in presenile and senile (presenile and senile) age:
1. Alzheimer's (atrophic) type of dementia, which is based on primary degenerative processes in nerve cells.
2. Vascular type of dementia, in which degeneration of the central nervous system develops a second time, as a result of severe circulatory disorders in the vessels of the brain.
3. Mixed type, which is characterized by both mechanisms of the development of the disease.

Clinical course and prognosis

In cases where the underlying pathology is not prone to development (for example, in post-traumatic dementia), with adequate treatment, a significant improvement is possible due to the development of compensatory reactions (other parts of the cerebral cortex take over part of the functions of the affected area).

However, the most common types of dementia - Alzheimer's disease and vascular dementia - tend to progress, therefore, when talking about treatment, in these diseases, we are talking only about slowing down the process, social and personal adaptation of the patient, prolonging his life, removing unpleasant symptoms, etc. .P.

And finally, in cases where the disease that caused dementia progresses rapidly, the prognosis is extremely unfavorable: the death of the patient occurs several years or even months after the first signs of the disease appear. The cause of death, as a rule, is various concomitant diseases (pneumonia, sepsis), which develop against the background of violations of the central regulation of all organs and systems of the body.

Severity (stages) of dementia

Light degree

moderate degree

severe dementia

Therefore, in the case of severe dementia, hourly monitoring of the patient (at home or in a specialized institution) is necessary.

Diagnostics

• signs of a decrease in the ability to abstract thinking (according to an objective study);
• symptoms of a decrease in the criticality of perception (found when building real plans for the next period of life in relation to oneself and others);
• three "A" syndrome:
  • aphasia - various kinds of violations of already formed speech;
  • apraxia (literally "inactivity") - difficulties in performing purposeful actions while maintaining the ability to move;
  • agnosia - a variety of violations of perception with the preservation of consciousness and sensitivity. For example, the patient hears sounds, but does not understand the speech addressed to him (auditory agnosia), or ignores a part of the body (does not wash or does not put on one foot - somatognosia), or does not recognize certain objects or people's faces with intact vision (visual agnosia) etc.;
• personal changes (rudeness, irritability, the disappearance of shame, a sense of duty, unmotivated attacks of aggression, etc.).

It should be noted that in order to make a reliable diagnosis of dementia, it is necessary that all of the above signs have been observed for at least 6 months. Otherwise, we can only talk about a presumptive diagnosis.

Differential diagnosis of organic dementia

Pseudo-dementia often develops also after a severe psychological shock. Some psychologists explain this kind of sharp decline in all cognitive functions (memory, attention, the ability to perceive and meaningfully analyze information, speech, etc.) as a defensive reaction to stress.

Another type of pseudodementia is a weakening of mental abilities with metabolic disorders (avitaminosis B 12, lack of thiamine, folic acid, pellagra). With timely correction of violations, the signs of dementia are completely eliminated.

Differential diagnosis of organic dementia and functional pseudodementia is quite complicated. According to international researchers, about 5% of dementias are completely reversible. Therefore, the only guarantee of a correct diagnosis is long-term observation of the patient.

Dementia of the Alzheimer's type

The concept of dementia in Alzheimer's disease

Subsequently, such violations were also found in cases where the disease manifested much later. This was a revolution in the views on the nature of senile dementia - before that, it was believed that senile dementia is a consequence of atherosclerotic lesions of the cerebral vessels.

Dementia of the Alzheimer's type today is the most common type of senile dementia, and, according to various sources, makes up from 35 to 60% of all cases of organic dementia.

Risk factors for developing the disease

• age (the most dangerous milestone is 80 years);
• the presence of relatives suffering from Alzheimer's disease (the risk increases many times if the pathology in relatives has developed before the age of 65);
• hypertonic disease;
• atherosclerosis;
• elevated plasma lipid levels;
• obesity;
• sedentary lifestyle;
• diseases occurring with chronic hypoxia (respiratory failure, severe anemia, etc.);
• traumatic brain injury;
• low level of education;
• lack of active intellectual activity during life;
• female.

First signs

For memory impairment in dementia of the Alzheimer's type, the so-called Ribot's law is characteristic: first, short-term memory is impaired, then recent events are gradually erased from memory. The memories of a distant time (childhood, youth) are preserved for the longest time.

Characteristics of the advanced stage of progressive dementia of the Alzheimer's type

Memory gaps are often replaced by fictitious events (the so-called confabulation- false memories). Gradually, the criticality of the perception of one's own state is lost.

At the advanced stage of progressive dementia, disorders of the emotional-volitional sphere begin to appear. The following disorders are most characteristic of senile dementia of the Alzheimer's type:

• egocentrism;
• grouchiness;
• suspicion;
• conflict.

Other types of violations of normal behavior often develop:

• sexual incontinence;
• gluttony with a special inclination to sweets;
• craving for vagrancy;
• fussy erratic activity (walking from corner to corner, shifting things, etc.).

Diagnosis of dementia of the Alzheimer's type

Treatment

In the early stages, the following drugs showed a good effect:

• homeopathic remedy ginkgo biloba extract;
• nootropics (piracetam, cerebrolysin);
• medicines that improve blood circulation in the vessels of the brain (nicergoline);
• stimulator of dopamine receptors in the central nervous system (piribedil);
• phosphatidylcholine (part of acetylcholine, a CNS mediator, therefore improves the functioning of neurons in the cerebral cortex);
• actovegin (improves the utilization of oxygen and glucose by brain cells, and thereby increases their energy potential).

Forecast

The earlier Alzheimer's develops, the faster dementia progresses. Patients under 65 years of age (early senile dementia or presenile dementia) develop early neurological disorders (apraxia, agnosia, aphasia).

Vascular dementia

Dementia in cerebrovascular disease

At the same time, as a rule, dementia that developed after vascular accidents, such as:
1. Hemorrhagic stroke (rupture of the vessel).
2. Ischemic stroke (blockage of the vessel with the cessation or deterioration of blood circulation in a certain area).

In such cases, massive death of brain cells occurs, and the so-called focal symptoms come to the fore, depending on the location of the affected area (spastic paralysis, aphasia, agnosia, apraxia, etc.).

So the clinical picture of post-stroke dementia is very heterogeneous, and depends on the degree of damage to the vessel, the range of the blood-supplying area of ​​the brain, the compensatory capabilities of the body, as well as the timeliness and adequacy of medical care provided in case of a vascular accident.

Dementias that occur with chronic circulatory insufficiency develop, as a rule, in old age, and show a more uniform clinical picture.

What disease can cause vascular dementia?

The second large group of diseases leading to chronic hypoxia of brain cells is vascular damage in diabetes mellitus (diabetic angiopathy) and systemic vasculitis, as well as congenital disorders in the structure of cerebral vessels.

Acute cerebrovascular insufficiency can develop with thrombosis or embolism (blockage) of the vessel, which often occurs with atrial fibrillation, heart defects, and diseases that occur with an increased tendency to thrombosis.

Risk factors

• hypertension, or symptomatic arterial hypertension;
• elevated plasma lipid levels;
• systemic atherosclerosis;
• cardiac pathologies (ischemic heart disease, arrhythmias, damage to the heart valves);
• sedentary lifestyle;
• overweight;
• diabetes;
• tendency to thrombosis;
• systemic vasculitis (vascular disease).

Symptoms and course of senile vascular dementia

Another harbinger of developing vascular dementia is the slowness of intellectual activity, so for the early diagnosis of cerebrovascular accidents, tests for the speed of performing simple tasks are used.

Early signs of developed dementia of vascular origin include violations of goal setting - patients complain of difficulties in organizing elementary activities (planning, etc.).

In addition, already in the early stages, patients experience difficulties in analyzing information: it is difficult for them to distinguish between the main and the secondary, to find common and different between similar concepts.

Unlike dementia of the Alzheimer's type, memory impairment in dementia of vascular origin is not so pronounced. They are associated with difficulties in reproducing the perceived and accumulated information, so that the patient easily remembers the "forgotten" when asking leading questions, or chooses the correct answer from several alternative ones. At the same time, memory for important events is retained for a sufficiently long time.

For vascular dementia, disorders of the emotional sphere are specific in the form of a general decrease in the background of mood, up to the development of depression, which occurs in 25-30% of patients, and severe emotional lability, so that patients can cry bitterly, and in a minute move on to quite sincere fun.

Signs of vascular dementia include the presence of characteristic neurological symptoms, such as:
1. Pseudobulbar syndrome, which includes a violation of articulation (dysarthria), a change in the timbre of the voice (dysphonia), less often - a violation of swallowing (dysphagia), violent laughter and crying.
2. Gait disturbances (shuffling, mincing gait, "skier's gait", etc.).
3. Decreased motor activity, the so-called "vascular parkinsonism" (poor facial expressions and gestures, slowness of movement).

Vascular dementia, which develops as a result of chronic circulatory failure, usually progresses gradually, so that the prognosis largely depends on the cause of the disease (hypertension, systemic atherosclerosis, diabetes mellitus, etc.).

Treatment

In addition, pathogenetic treatment is standardly prescribed: piracetam, cerebrolysin, actovegin, donepezil. The regimens for taking these drugs are the same as for dementia of the Alzheimer's type.

Senile dementia with Lewy bodies

The causes and mechanisms of development of senile dementia with Lewy bodies are not fully understood. Just like in Alzheimer's disease, the hereditary factor is of great importance.

According to theoretical data, senile dementia with Lewy bodies is the second most common, and accounts for about 15-20% of all senile dementia. However, during life, such a diagnosis is made relatively rarely. Typically, these patients are misdiagnosed with vascular dementia or Parkinson's disease with dementia.

The fact is that many of the symptoms of dementia with Lewy bodies are similar to the listed diseases. Just as in the vascular form, the first symptoms of this pathology are a decrease in the ability to concentrate, slowness and weakness of intellectual activity. In the future, depression develops, a decrease in motor activity by the type of parkinsonism, walking disorders.

At the advanced stage, the clinic of dementia with Lewy bodies in many ways resembles Alzheimer's disease, since delusions of damage, delusions of persecution, delusions of twins develop. With the progression of the disease, delusional symptoms disappear due to the complete exhaustion of mental activity.

However, senile dementia with Lewy bodies has some specific symptoms. It is characterized by the so-called small and large fluctuations - sharp, partially reversible violations of intellectual activity.

With small fluctuations, patients complain of temporary impairments in the ability to concentrate and perform some task. With large fluctuations, patients note impairments in the recognition of objects, people, terrain, etc. Often, disorders reach the degree of complete spatial disorientation and even confusion.

Another characteristic feature of dementia with Lewy bodies is the presence of visual illusions and hallucinations. Illusions are associated with a violation of orientation in space and are intensified at night, when patients often mistake inanimate objects for people.

A specific feature of visual hallucinations in dementia with Lewy bodies is their disappearance when the patient tries to interact with them. Often, visual hallucinations are accompanied by auditory (talking hallucinations), but auditory hallucinations do not occur in their pure form.

As a rule, visual hallucinations accompany large fluctuations. Such attacks are often provoked by a general deterioration in the patient's condition (infectious diseases, overwork, etc.). When leaving a large fluctuation, patients partially amnesia what happened, intellectual activity is partially restored, however, as a rule, the state of mental functions becomes worse than the initial one.

Another characteristic symptom of dementia with Lewy bodies is a violation of behavior during sleep: patients can make sudden movements, and even injure themselves or others.

In addition, with this disease, as a rule, a complex of autonomic disorders develops:

• orthostatic hypotension (a sharp decrease in blood pressure when moving from a horizontal to a vertical position);
• arrhythmias;
• disruption of the digestive tract with a tendency to constipation;
• urinary retention, etc.

With confusion, acetylcholinesterase inhibitors (donepezil, etc.) are prescribed, in extreme cases, atypical antipsychotics (clozapine). The appointment of standard neuroleptics is contraindicated due to the possibility of developing severe movement disorders. Non-frightening hallucinations with adequate criticism are not subject to special medication elimination.

Small doses of levodopa are used to treat the symptoms of parkinsonism (be very careful not to cause an attack of hallucinations).

The course of dementia with Lewy bodies is rapidly and steadily progressive, so the prognosis is much more serious than in other types of senile dementia. The period from the appearance of the first signs of dementia to the development of complete insanity takes, as a rule, no more than four to five years.

Alcoholic dementia

Almost all alcoholics at the stage of development of alcoholic degradation of the personality (the third, last stage of alcoholism) show atrophic changes in the brain (expansion of the ventricles of the brain and furrows of the cerebral cortex).

Clinically, alcoholic dementia is a diffuse decrease in intellectual abilities (impairment of memory, concentration of attention, ability to abstract thinking, etc.) against the background of personal degradation (coarseness of the emotional sphere, destruction of social ties, primitivism of thinking, complete loss of value orientations).

At this stage in the development of alcohol dependence, it is very difficult to find incentives that encourage the patient to treat the underlying disease. However, in cases where it is possible to achieve complete abstinence within 6-12 months, the signs of alcoholic dementia begin to regress. Moreover, instrumental studies also show some smoothing of the organic defect.

epileptic dementia

Epileptic dementia is characterized by slowness of thought processes, the so-called viscosity of thinking (the patient cannot distinguish the main from the secondary, and gets hung up on describing unnecessary details), memory loss, and vocabulary impoverishment.

The decrease in intellectual abilities occurs against the background of a specific change in personality traits. Such patients are characterized by extreme selfishness, malice, vindictiveness, hypocrisy, quarrelsomeness, suspiciousness, accuracy up to pedantry.

The course of epileptic dementia is steadily progressive. With severe dementia, malice disappears, but hypocrisy and obsequiousness persist, lethargy and indifference to the environment increase.

How to prevent dementia - video

Answers to the most frequently asked questions about causes, symptoms and
dementia treatment

Are dementia and dementia the same thing? How does dementia progress in children? What is the difference between childhood dementia and oligophrenia

To refer to childhood dementia, the term "mental retardation" or oligophrenia is used. This name is retained when the patient reaches adulthood, and rightly so, since dementia that arose in adulthood (for example, post-traumatic dementia) and mental retardation proceed differently. In the first case, we are talking about the degradation of an already formed personality, in the second - about underdevelopment.

Unexpectedly appeared untidiness - is this the first sign of senile dementia? Are symptoms such as untidiness and slovenliness always present?

At the same time, patients with dementia in the early stages of the disease can be quite independent and accurate in their usual everyday environment. Sloppiness may be the first sign of dementia only when the development of dementia is already accompanied by depression, exhaustion of the nervous system, or psychotic disorders already in the early stages. This kind of debut is more typical for vascular and mixed dementias.

What is mixed dementia? Does it always lead to disability? How is mixed dementia treated?

It is believed that circulatory disorders in the vessels of the brain can trigger or enhance the primary degenerative processes characteristic of Alzheimer's disease and dementia with Lewy bodies.

Since the development of mixed dementia is caused by two mechanisms at once, the prognosis for this disease is always worse than for the "pure" vascular or degenerative form of the disease.

The mixed form is prone to steady progression, therefore it inevitably leads to disability, and significantly reduces the patient's life.
The treatment of mixed dementia is aimed at stabilizing the process, therefore, it includes the fight against vascular disorders and the mitigation of the developed symptoms of dementia. Therapy, as a rule, is carried out with the same drugs and according to the same schemes as for vascular dementia.

Timely and adequate treatment for mixed dementia can significantly prolong the patient's life and improve its quality.

Among my relatives there were patients with senile dementia. What is my chance of developing a mental disorder? What is the prevention of senile dementia? Are there any medicines that can prevent the disease?

The risk of developing the disease increases if senile dementia in relatives developed at a relatively early age (before 60-65 years).

However, it should be remembered that hereditary predisposition is only the presence of conditions for the development of a particular disease, so even an extremely unfavorable family history is not a sentence.

Unfortunately, today there is no consensus on the possibility of specific drug prevention of the development of this pathology.

Since risk factors for the development of senile dementia are known, measures to prevent mental illness are primarily aimed at eliminating them, and include:
1. Prevention and timely treatment of diseases that lead to circulatory disorders in the brain and hypoxia (hypertension, atherosclerosis, diabetes mellitus).
2. Dosed physical activity.
3. Constant intellectual activity (you can make crosswords, solve puzzles, etc.).
4. Quit smoking and alcohol.
5. Prevention of obesity.

In general, you can easily wander around the house like this on weekends or go out with friends. But if you have an important business meeting, going out, or the first date with the man of your dreams, be sure to check your image for the absence of these 10 slovenliness markers!

Hair band on hand

It's not a bracelet or a watch, it's a hair tie, and the only visible place it should be is your head. Of course, it's convenient to always have it on your wrist, but just imagine how unpleasant it will be for you to see a black elastic cord on your arm in your best friend's wedding photo album.

Two bulky bags together (and one of them is a canvas shopping bag)

Popular

Canvas shopping bags are not designed for everyday wear as an “extra” bag, but rather for shopping and other similar household chores. If you carry such a bag every day, then you inevitably look unassembled, and some stylists are sure that by constantly wearing this “duffel bag” you become like a homeless woman who carries everything with her. Think about whether you need all the things from the second bag? Go through everything that you carry with you, and you will surely come to the conclusion that there is a whole bunch of unnecessary junk in a canvas shopping bag.

Hairstyle in the style of "either a bun, or a tail"

Somehow collected in a cross between a bun and a tail, hair can ruin any, even the most thoughtful and stylish look. Therefore, if you have a meeting with someone important to you, take a couple of seconds to modify this misunderstanding into a regular ponytail.

Underwear peeking out from under clothes

A protruding bra strap, slimming panties peeking out from under the waist of a mini-skirt - if your underwear constantly reminds others of your presence, then they may get the impression of you as a slob who is too lazy to even just look at himself in the mirror before leaving the house .

Constantly trying to fix clothes

The constant pulling up and pulling up of clothes irritates not only yourself, but also your surroundings - people get the feeling that you are not able to find comfortable clothes for yourself. If you can't comfortably wear something, it's best not to wear it outside of the house.

Your pet hair on clothes

If you think that this is imperceptible, you are deeply mistaken - as a result of such an oversight, you become that very “strong independent woman” from the joke about forty cats. As you understand, your potential boyfriend will not be attracted to this at all.

Pants that are too long and drag on the ground

Oh, how great flared jeans and wide trousers look on the stars! But the beauty of this is largely due to the fact that famous women of fashion wear such trousers with heels, preventing the legs from dragging on the ground. Of course, you're not likely to wear your flared jeans with the same pair of ankle boots, which have a heel height that's perfect for not picking up all the dirt from the city streets. There are two ways out: either shorten the trousers for flat shoes (but what about heels?), Or switch to narrower and shorter models.

Your blouse keeps coming out of your jeans and skirts

A blouse that is constantly hanging halfway from the belt of trousers or a skirt looks sloppy, and trying to put it back in a public place is hardly decent. If you like a perfectly tucked-in blouse, look no further than bodysuit blouses.

Your shoelaces are always in a mess

This is actually probably the smallest item on our list, but paired with anything else, it can further exacerbate the degree of sloppiness of the image, so pay attention to how the laces on your shoes look - it is better that they are tied neatly and equally.

Diogenes Syndrome is a psychiatric term-eponym denoting a mental disorder that manifests itself in the neglect of hygiene standards, the accumulation of unnecessary things, littering the place of residence with unsuitable objects and garbage. As a rule, this deviation is observed in adulthood and is characterized by a desire for isolation from others.

The disease got its name from the ancient Greek philosopher Diogenes, who preaches the principle of contentment with little. According to the facts, the thinker lived in a barrel, ate leftovers and was famous for his provocative actions. People suffering from this syndrome are so prone to slovenliness that their lifestyle brings a lot of discomfort to both family members and neighbors. According to the facts, the disorder is diagnosed in 3% of the elderly.

Features of the disease, its symptoms and causes

For the first time, the disease began to be considered as a separate psychopathological syndrome back in 1966. The name "Diogenes syndrome" was proposed by British scientists in 1975. To date, there are ongoing discussions about the correctness of just such a name for the disease, many psychiatrists consider the terms “syllogomania” or “senile squalor syndrome” to be the most suitable for use. The fact is that the fundamental symptom of this mental disorder is the pathological accumulation of unnecessary things.

The ancient Greek philosopher, after whom the disease got its name, did not suffer from collecting unusable objects. He lived in poverty and the only object of his possession was a cup, which, in the end, the thinker broke due to the philosophical ideas of asceticism.

In domestic psychiatry, another name for this psychopathology is widely used - "Plyushkin's syndrome". As you know, this character of Gogol's great poem was famous for his stinginess and craving for the accumulation of unnecessary things with which he completely filled up his home.

Among the main symptoms of the disease are:

• pathological hoarding;
• aggressiveness and negativism towards persons who criticize the patient;
• lack of self-criticism of one's condition;
• non-observance of hygiene rules, carelessness;
• avarice;
• isolation from the public;
• apathy, indifference;
• lack of shame;
• self-disdain.

Collecting unusable things sometimes clutters up the home of pathological misers so much that it literally turns into a garbage dump. Hoarders carry various unnecessary items to themselves, which, in their opinion, may come in handy sooner or later. The place of residence of the drive is sometimes so crowded with all sorts of rubbish that it becomes even difficult to move around the house. People suffering from this syndrome drag everything from the street: from old, broken furniture to empty cardboard boxes, some even managed to store rotten vegetables and fruits. An unpleasant smell emanates from all this rubbish, cockroaches and rats often start up in the room. The greatest discomfort is received by family members and neighbors living next to the pathological drive.

As a rule, any criticism of the patient is not perceived, and any offered help is immediately rejected. Pathological "Diogenes" after several complaints about their lifestyle become suspicious, taciturn and secretive. Sometimes it is simply impossible to establish contact with them, relatives have to resort to forcible hospitalization of the patient (in extremely difficult conditions).

Patients do not realize the seriousness of their condition, they answer many claims that this is their lifestyle, a hobby. According to the accumulator, any thing can be used: “old boards can be used to build a barn,” and “you can store something in empty tea boxes.” Guided by this principle, a person turns his life into an obsessive search for unusable objects.

The appearance of such people is untidy, often they do not care about how they look. The neglect of hygiene makes them look like homeless vagrants. In matters of nutrition, syllologomaniacs are also not picky, as a rule, they save on food. There are many cases when patients ate leftovers from garbage dumps simply because they did not want to spend extra money on food. Essentials and medicines, according to pathological drives, are also not very important. Many patients do not leave the house for months, considering communication with people useless and boring. Neglect of one's health and social isolation sometimes leads to sad consequences. The facts are that some recluses die all alone, surrounded by garbage barricades.

Another sign of disorder is a lack of shame. Syllogomaniacs can publicly defecate, change clothes or even undress. They are driven by indifference to what others think, actions take place on the principle of "I want and I do." Quite often, patients end up in the police department because of their shameless behavior and violation of the rules of order.

An interesting fact is that often people suffering from syllogomania are the owners of large savings, although they live like beggars. There are many cases when the former rich and influential personalities became vagabonds, coming home only to bring another rubbish. So, one American millionaire was so stingy that at the age of forty he simply decided to live in a landfill in order to spend less money.

Among the causes of the disease are:

• organic lesions of the frontal lobes of the brain;
• mental disorders of old age;
• alcoholism;
• pathological tendency to collect.

According to psychophysiological studies, the disease can occur as a result of damage to the frontal lobes of the brain. The cause of such lesions can be injuries, brain diseases, unsuccessful operations. These areas of the cortex are responsible for decision-making, and it is their damage that leads to the development of a pathological craving for accumulation.

Sometimes syllogomania is only part of a serious mental illness. Most often, the syndrome occurs in obsessive-compulsive disorder, senile dementia,.

How to treat Diogenes syndrome

Therapy of the disease should be carried out without fail, since its symptoms can sometimes signal the development of a more serious psychopathology.

So, how to treat Diogenes syndrome? As pharmacotherapy, sedatives, antidepressants, antipsychotics are widely used. Central to the diagnosis of the syndrome is the conduct of computed tomography of the brain, to determine the degree of damage to brain areas. Psychotherapy, as a rule, is not used, since the basis of the disease lies in the organic lesion.

The main point in the treatment of the disease is family support and care. Often, lonely people, deprived of family love and mutual understanding, suffer from Diogenes syndrome.