Senile depression, senile dementia, vascular psychoses

People over 60 years of age often experience mental disorders with confusion, with symptoms reminiscent of schizophrenia and bipolar disorder. They are often accompanied by delusions, hallucinations, and paranoid manifestations without dementia. In this case, doctors suspect senile psychosis in elderly people. In psychiatry it has a synonym - senile. Relatives of this category of patients have a question: what to do in this case. We recommend contacting the Moscow clinic “Leto”. Our specialists treat mental disorders, including acute/chronic psychotic disorders. Phone number of our medical center: 8(969)060-93-93 . You can call him at any time and get a free consultation.

Senile psychosis, features and causes

The frequency of senile psychotic disorders is in the range of 12-25% of all mental illnesses in old age. The exact causative factors of the disease have not yet been established.

Psychiatrists suggest that the disease develops as a result of age-related changes, character traits and the influence of unfavorable living conditions.

More often, psychosis in an elderly person is characterized by:

• Women.
• Depressed individuals.
• Patients with a hereditary predisposition to this pathology.
• Persons with long-term chronic somatic diseases.

Symptoms of age-related depression

The older the age group, the more often depression and dementia (senile insanity) are registered in it. Often elderly patients at our clinic complain of the following symptoms:

1. Negative view of objects and events in life. An elderly man expresses dissatisfaction with youth, authorities, and the weather. Everything that was before is good, and everything that is now is bad.
2. Constant grievances , especially against loved ones, a feeling of “damage done . An elderly family member unreasonably reproaches his loved ones that everyone has abandoned him, they want to take something away from him, they don’t love him, and no one needs him, that they are plotting something against him and want to harm him. This is not behavioral egoism or “harmfulness of character” - but a symptom of vascular disease of the brain (dementia or senile insanity).
3. Impaired ability for integrative brain functions - recall, memorization, thinking. More often, memory for recent events suffers, while events that happened many years ago are remembered well.
4. Cardiovascular attacks due to the slightest stress. A small stimulus is perceived as large, and the released stress hormones “hit” the blood vessels, hence a disruption of the heart rhythm, a hypertensive crisis or a heart attack.
5. Pain in the back, joints, legs, head. Against the background of depression, the pain threshold always decreases and minor pains from arthrosis and osteochondrosis are perceived more clearly.

If you see such symptoms, seek help from a neurologist or psychiatrist. Perhaps brain cells die daily and in large numbers, and it is dangerous to wait. At the same time, if you start treatment in time, its results can be very noticeable. We often see cases of rapid, within 1-2 months, transformation of older people into energetic, positive, active and internally young people. Blood pressure and heart behavior are much calmer.

Senile psychosis, types

Doctors at our clinic use the generally accepted classification of the disease.

It includes:

• Affective reactions.
• Paraphrenia.
• States of confusion.
• Mental disorders in severe internal diseases.

Each variant has a dominant syndrome, according to which their differentiation is made.

Diagnostic criteria

In the early stages, it is almost impossible to determine the presence of the disease, since it has a lot of symptoms similar to other pathologies: the cardiovascular system, tumors and other problems.

The reason for the diagnosis is a progressive impoverishment of the psyche, leading over several years to irreversible dementia.

Computed tomography scans also detect hydrocephalus or diffuse brain atrophy.

A visit to the doctor is mandatory if the patient has a number of factors: disorders for more than six months, leading to disturbances in social, professional, and daily activities. At the same time, the person has a completely clear consciousness, there are no mental disorders that could lead to a decrease in intelligence.

Differentiated diagnosis

Differential diagnosis helps to distinguish senile syndrome from diseases with similar symptoms, for example, schizophrenia.

Dementia is often accompanied by depressive disorders (pseudo-dementia), so differentiating the disease is quite difficult.

How does psychosis manifest in the elderly?

Senile psychotic disorders identified by specialists at our health center are divided into several types. They can occur in isolation, with periodic attenuation and new exacerbations. Sometimes one set of symptoms is reduced to another. There are also isolated mental disorders that go into stable remission, which is an indicator of their effective cure. Let's consider the main symptom complexes.

Acute forms of senile psychoses

These are the problems our psychiatrists most often have to deal with.

Their development is caused by somatic ailments:

• Cardiovascular and respiratory failure.
• Hypovitaminosis.
• Diseases of the kidneys and liver.

Patients exhibit characteristic disorders:

• 
  Partial or complete disorientation in space and time with confusion.

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• Motor restlessness.
• Anxiety.
• Transient hallucinatory visions.
• Crazy statements.

The duration of symptoms is several days, less often weeks. After the end of the attack, prolonged asthenia and mild lethargy remain. The episode may be repeated.

Chronic senile depression

The severity of clinical manifestations of this form depends on the age of the patients (usually women).

The psychotic reaction consists of:

• Apato-adynamic complex.
• “Silent” depression, in which few people pay attention to the emerging symptoms. And this kind of patient is prone to suicide, which is a complete surprise to others.
• Hypochondriacal complaints with ideas of self-accusation, up to Cotard's delirium.

This senile psychosis lasts a long time - 10 or more years. Thanks to successful therapy in our clinic, it is possible to significantly mitigate its course. Intellect in this form practically does not suffer, only memory problems appear over time.

Chronic paranoid psychoses

The main manifestation of the disorder is the patient’s delusional ideas, with fear of harm from loved ones.

They believe that relatives or neighbors want:

• Bring their death closer.
• Poison.
• Kick out of the home.
• Rob.

Patients turn to various authorities for “protection”, initiate checks, etc. This kind of client retains complete social adaptation, and their nonsense is perceived by department officials as the truth until the circumstances are fully clarified.

Hallucinosis

Characteristic of old age (after 80 years).

Manifest:

• Vivid visual, tactile and auditory hallucinations.
• Severe memory impairment.
• Dermatous delirium. A person is sure that he has parasites and foreign objects on his skin that he cannot get rid of. The patient itches, brushes off non-existent objects, consults dermatologists, and constantly washes clothes and bed linen.

Hallucinatory-paranoid form

This option is characterized by:

• Delirium of damage.
• By adding hallucinations of fantastic content.
• Echo thoughts with hearing voices (schizophrenia-like course).
• False ideas.

This type of disease occurs continuously with slow progression, leading to gradual memory loss.

Senile paraphrenia

Psychotic disorder is manifested by false memories with fantasizing. Patients talk about incredible events, meetings, acquaintances that had no place in their lives. Patients often develop euphoria and delusions of grandeur. The painful episode lasts 3-4 years, then begins to gradually fade.

MOST FREQUENTLY ASKED QUESTIONS ABOUT PSYCHOSES

There is currently a strong interest in the topic of psychosis (schizphoria, etc.) in society. The very concept of psychosis is perceived in different ways: from curiosity to fear. The phenomenon of psychosis is incorrectly and erroneously often used in philistine psychology. All sorts of prejudices and myths, on the one hand, see psychosis where there is none, and on the other hand, they prevent people from noticing and recognizing changes in time, both in themselves and in their loved ones. There is a denial of the problem out of fear of being branded a “crazy person.” Whereas timely seeking help from a specialist can help prevent the development of a serious disorder. The lack of adequate information gives rise to distrust in doctors, the emergence of a large amount of unfounded information both in the media and on the Internet, which undermines not only trust in the medical service, but also makes life difficult for those who suffer from this kind of disorder. People can become victims of healers and fortune tellers who speculate on this complex phenomenon. We have selected the most frequently asked questions, the answers to which must be given not only to the patients themselves and their relatives, but also to simply people who want to understand this phenomenon.

1.What is psychosis? Psychoses are manifestations of mental disorders, often chronic, which manifest themselves as disturbances in 4 main areas: perception, thinking, emotions and will, behavior and interaction with the outside world. In the realm of perception, we are talking about hallucinations, that is, actually and plausibly seeing, hearing or feeling something that does not actually exist. A thinking disorder manifests itself as delusion, that is, false, irrational judgments that are subjective in nature. Emotional disturbances can range from excessive activity, agitation with aggression and irritability to complete lack of will and isolation. Also in behavior, a person ceases to take into account social roles and the context of situations, to understand others; one may notice a stereotypical repetition of movements or performance of rituals. In psychiatry there is the concept of negative and positive symptoms. Positive symptoms are those mental phenomena that were not previously present in the psyche, but have appeared (delusions, hallucinations, aggression). Negative symptoms are those mental qualities that have begun to be lost and erased (unemotionality, memory loss, loss of social contacts). All these phenomena lead to a loss of connection with the outside world and interfere with the correct interpretation of reality, which explains one of the main signs of psychosis - a lack of criticality.

2.Can neurosis turn into psychosis? Psychosis is a disorder that is characterized by gross disturbances of the emotional-volitional sphere, changes in thinking and is accompanied by impaired criticality of one’s condition with impaired ability to distinguish internal experiences from external sources. With neurosis, emotional or physical manifestations of internal conflict come to the fore without disrupting thinking and being overly critical of one’s condition. Biological causes predominate in the occurrence of psychoses, while intrapersonal conflicts play a leading role in the occurrence of neuroses. The mechanisms underlying neurosis and psychosis are so different from each other that one does not transform into the other.

3. Can psychosis be cured? There are acute (transient) psychoses, which can more often be caused by acute stressful situations (life-threatening situations, loss of a loved one), intoxication (alcohol, popularly “delirium tremens”), infection (with meningitis), severe physical illness (with a heart attack). myocardium), with timely and correct drug treatment, their complete cure is possible without maintaining residual signs. In cases of chronic psychosis (example: schizophrenia, bipolar affective disorder), the course can be long. As with any chronic disease, there are periods of complete health, doctors call them remissions, and periods of exacerbation of the disorder. The prognosis largely depends on the correct treatment started in a timely manner.

4.What causes psychosis? Currently, medicine has adopted a multifactorial model, which shows that the development of the disease is influenced by a combination of several causes. The predominant reasons are still biological: changes in metabolism in the brain, namely the substance dopamine, which serves impulses, emotions, feelings of pleasure and motor activity, affects the severity of symptoms and their nature. In addition, psychosocial reasons can be identified: conflicts, mental trauma, tension, disharmonious relationships in the family, which will affect the course of the disease and the recovery process.

5. Is it possible to get psychosis if a relative suffered from it? There is a pattern that says that the closer the degree of relationship, the higher the risk of getting sick. However, it is worth remembering that predisposition is inherited. For the development of the disease itself, a combination of many factors is necessary. Currently, there are no reliable formulas by which this probability could be determined. The heredity factor plays the same role as in cancer, diabetes and arterial hypertension. It is known that if both parents suffered from the disease, then the risk is 50%, if only one of them, then the risk is estimated at 25%

6. Can psychosis be cured without medication? Unfortunately no. Since biological causes are dominant in the occurrence of psychoses, a special group of drugs is used to treat psychoses - antipsychotic drugs, another name for neuroleptics. Their effectiveness has now been proven and they are widely used in practice. Drug therapy is currently the most reliable and effective way to cope with acute symptoms and prevent their return. It is important that drug therapy is combined with individual and/or family psychotherapy, which will help the sufferer and his loved ones develop a real understanding of the disorder, teach them to cope with it, and take measures to prevent it. The social rehabilitation program will help you return to normal daily activities by restoring and improving social skills (communication with others, daily routine activities, rational behavior).

7. Are people in psychosis dangerous to others? In the acute stage of psychosis, when the understanding of reality is greatly impaired, i.e. it is misperceived (hallucinations), interpreted (delusions), and it is also impossible for a person to control his impulses, he can be dangerous to himself and others. However, the likelihood of an attack is quite low, because... The main experience of such patients is horror and anxiety, while rage and anger are secondary. It is very important then to behave correctly. Do not argue or convince a person that what is happening is wrong, do not find out the details of his experiences, and hide dangerous objects. You need to listen to him carefully and try to calm him down, ensure a calm environment, shouting or arguing is not allowed, stress in such a situation should be minimized. Try, but only if the person is calm, to persuade him to see a doctor. In other situations, you can seek emergency help.

8. Are people with psychosis able to work? A mental disorder is just like any physical illness, just like any physical illness, it can impose its limitations. People who experience psychosis exhibit disturbances of impulse to act and will, which should not be considered signs of human or moral weakness. The “pull yourself together” approach is similar to treating deafness through “willpower”. People suffering from psychosis may experience certain difficulties and, as a result, restrictions in performing work activities. Sometimes this requires the creation of certain conditions on the part of the employer (reducing the load, working hours, intensity, complexity of the work performed). At the same time, work is very important for such people, because... contributes to the preservation and restoration of thought processes, motivations and activity. However, in some cases, the disorder does not affect activity in any way, as evidenced by the examples of many talented scientists, writers and artists.

9. How dangerous are antipsychotic drugs? All antipsychotic drugs have a certain range of side effects. It is important to carefully select the type of drug and dose, taking into account the symptoms of the disease, age, and state of physical health. Currently, there are antipsychotics, when taken, the development of unpleasant side effects is minimized. There are also injectable forms of the drug, which can be taken 1-2 times a month. Trust in the doctor, agreement and discussion with him of the manifestations of the disease and side effects, setting realistic goals for treatment and adherence to the chosen treatment tactics are also of great importance.

10.Can people with psychosis start a family and have children? As with any disorder, this is not an obstacle. However, the partner must have complete, comprehensive and adequate information about the disease, its course and manifestations. It is also worth discussing in advance with doctors - geneticists, gynecologists, psychiatrists - all possible risks for future children and the process of the course and management of pregnancy. Therefore, it is necessary to approach this issue with greater prudence and become familiar with pregnancy planning methods.

11.Are people with psychosis able to make important decisions on their own? Yes, if the disease is in remission and there are no gross disturbances in the area of ​​thinking. The overwhelming majority of people suffering from psychosis during health are indistinguishable from people without a mental disorder. It is worth remembering that basically there is no total defeat of the personality, but only some of its aspects and functions suffer. Therefore, with timely treatment and adequate treatment in combination with rehabilitation methods, it is possible to relieve acute symptoms and return a person to a full life.

With timely, proper treatment and organization of life with psychosis, incl. with schizophrenia, you can live a full life: study, work, have a family and children, favorite activities and friends.

Diagnostics

At the appointment, the doctor at our clinic draws attention to characteristic symptoms that indicate the client has senile psychosis.

During examination and questioning of patients, the following is revealed:

• Preservation of intelligence.
• Stability and limited symptoms.
• Duration of deviations.

It is very important for a psychiatrist to distinguish senile psychosis from schizophrenia, manifestations of vascular pathology. For differential diagnosis, CT and MRI of the brain are used, which can reveal anatomical vascular defects and changes in brain tissue characteristic of other diseases.

How is the disease detected during diagnosis?

Upon admission to the clinic, the doctor examines the patient and takes into account all existing abnormalities before making a diagnosis.

The diagnostic process includes:

• Conversation with the client and relatives.
• Examination and identification of specific symptoms.
• Testing.
• Involvement of other specialists if necessary.

It is important to exclude other pathologies: schizophrenia, neuroses, psychoses associated with the use of psychoactive substances and other diseases.

The diagnosis ends with laboratory tests and an ECG.

How to get to our medical center

All you have to do is call 8(969)060-93-93 . The call center manager will provide all the necessary information. From him you will learn the methods and cost of the upcoming treatment. The consultant will help you choose a room. After making an appointment, all you have to do is drive to the clinic. Our hospital is located in a convenient location. Getting to it will not be difficult, either by public transport or by your own. In cases where there are problems with the client, you can order a transfer service from us. Our staff will deliver the patient using convenient transport. All types of diagnostics and therapy are provided anonymously.

Set of measures

Once the clinical picture has been studied and an accurate diagnosis has been made, treatment of the patient can begin. With the permission of the patient's relatives, he is placed in a medical facility.

The main goal of treatment is to arrest the progression of the disease, symptomatic treatment and alleviation of these characteristic symptoms.

In case of depressive conditions, a specialist may prescribe psychotropic drugs such as Melipramine, Pyrazidol, Azafen. In some cases, drugs can be combined at a certain dose. For all other types of senile psychosis, Propazine, Sonapax, and Haloperidol are prescribed.

In each specific case, the patient is prescribed an individually selected drug and additional medications that correct the accompanying symptoms.

Typically, the acute form of senile psychosis responds more successfully to treatment. A protracted disease can only be suppressed with medications, but it is impossible to completely get rid of it.

What should relatives and friends do?

To maintain the mental state of a patient diagnosed with senile psychosis, the people around him must be understanding of the current situation and understand that this process is inevitable and incurable. This disease is objective and does not depend at all on the patient himself.

In severe cases of senile psychosis, patients require special care, which is best organized in a medical facility. If the patient is inactive, bedsores may appear, which can significantly worsen the health condition.

Patients who are characterized by untidiness require special care. Thus, relatives or medical personnel (depending on the location of the patient) are required to wipe him with camphor alcohol, wash him regularly, change bed linen and prevent sleeping on a wet bed. Cleansing enemas should also be regular.

Cost of services

This list does not contain all prices for services provided by our clinic. The full price list can be found on the “Prices” , or by calling: 8(969)060-93-93. Initial consultation is FREE!

Where can I invite a psychiatrist to examine a patient in a state of psychosis at home?

There are three types of institutions from which you can call a psychiatrist.

1. Psychoneurological dispensary (PND). This is a government institution, like a clinic, where psychiatrists work. In cities, each psychiatrist is even assigned his own precinct, that is, each city resident has his own local psychiatrist! The responsibilities of such a psychiatrist include home visits to examine seriously ill patients (and psychosis is a serious condition). You, as a relative or loved one, can contact a psychiatrist (in person, through the registry, or by telephone) with a request for an examination at home. An experienced doctor, during a conversation with you (relatives or friends), will draw a conclusion about the patient’s condition and give advice on what to do while you wait for the doctor to arrive.

2. 
   Ambulance. If the patient is agitated, aggressive, poses a danger to himself or others, there is no way to leave him alone and there is no time, then call an ambulance for psychiatric help. For more details on how to do this, see here

3. Private psychiatric clinics. In recent years, their number has been increasing. You can invite a psychiatrist from a private psychiatric clinic to examine the patient. Or call a special team of specialists to provide emergency psychiatric care or hospitalization. The ROSA Clinic is one of the leading private psychiatric clinics in Russia, which operates around the clock and has its own comfortable inpatient department for the treatment of psychosis, and also has a staff of psychiatrists who provide consultations at home.

Treatment of senile psychosis

To relieve the manifestations of psychotic disorders, mandatory medication correction is required. Medicines are selected after examination on an individual basis. The doctor must take into account the characteristics of the patient, age, character, temperament and other aspects of the personality.

Drug therapy is based on:

• 
  Neuroleptics that eliminate delusions and hallucinations.

• Antidepressants that relieve depression and anxiety.
• Sedatives that relieve the patient of fears, agitation, and sleep disturbances.

The treatment complex necessarily includes the following:

• Nootropics.
• Vitamins.
• Drugs for the treatment of somatic pathology.

Against the background of pharmacotherapy, psychologists work with clients, correcting their behavior. Each of our patients is cared for and monitored. Medical staff quickly and effectively provide relief to the sick.

Causes of the disease

The etiology and pathogenesis of senile psychosis have not yet been well studied.
According to statistics, women are more susceptible to this problem than men. The risk of developing the disease increases if there are already precedents of senile psychosis in the family, that is, the hereditary factor plays a large role. The main reasons for the development of the disease are:

• gradual age-related death of groups of cells;
• degenerative processes in the brain;
• Various infectious diseases can affect the development of the disease;
• somatic pathologies;
• traumatic brain injuries;
• traumatic circumstances.

Pathogenesis can also be affected by:

• physical inactivity;
• sleep disorders;
• malnutrition (incorrect diet);
• problems with hearing and vision.

Forecast and preventive measures

A stay in the hospital of our center with timely assistance provided gives reason to talk about a positive prognosis after treatment of acute conditions. Chronic psychotic forms, unfortunately, have an unfavorable course; doctors can only achieve temporary remission. After discharge, clients, under the supervision of relatives, should follow the recommended regimen, avoid neuropsychic overload, and treat existing pathologies of internal organs. When the first signs of exacerbation appear, simply dial 8(969)060-93-93.

Why does delirium develop in an elderly person?

Involutional processes caused by age most strongly affect brain functions. In connection with these changes, the activity of the central nervous system follows the path of simplification, reverse development, only with pronounced dynamics. The first signs of involution are observed in almost any person who has crossed the forty-five-year mark. And after 60, mental regression manifests itself with obvious signs, expressed to varying degrees.

If you pay attention to emerging deviations in a timely manner, they can be significantly stopped. Therefore, any person who has lived to old age must take independent steps to prevent the appearance of senile ailments. Timely provision of advisory assistance and implementation of medical recommendations will help maintain mental adequacy longer and avoid the development of pathology accompanied by delusional states.

What to expect?

The most favorable prognosis is given to patients with an acute form of the disease, especially if medical help was sought on time and consciousness was not in a state of confusion for long.
The chronic form does not entail anything good and the prognosis in this case is not comforting: the disease develops from one to ten years and the later this process begins, the better, since ultimately the disease ends with cachexia, problems with making movements and even constructing phrases and pronunciation of words.

Experts believe that if you start preventing senile psychosis at the age of 35, then in the future a person will be able to avoid a similar disease:

• the person must be physically active;
• an important factor is the development of mental abilities;
• attention to body weight;
• blood pressure control;
• cholesterol control;
• proper nutrition.