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It is necessary to distinguish between neurotic syndromes themselves and the neurotic level of disorders. The neurotic level of the disorder (borderline neuropsychiatric disorders), according to most domestic psychiatrists, also includes asthenic syndromes and non-psychotic affective disorders (subdepression, hypomania). The actual neurotic syndromes include obsessive (obsessive-phobic, obsessive-compulsive syndrome), senestopathic and hypochondriacal, hysterical syndromes, as well as depersonalization-derealization syndromes, syndromes of overvalued ideas.
Obsessive syndrome includes, as the main symptoms, obsessive doubts, memories, ideas, an obsessive feeling of antipathy (blasphemous and blasphemous thoughts), “mental chewing gum,” obsessive drives and associated motor rituals. Additional symptoms include emotional stress, a state of mental discomfort, powerlessness and helplessness in the fight against obsessions. In their “pure” form, affectively neutral obsessions are rare and are represented by obsessive philosophizing, counting, obsessive remembering of forgotten terms, formulas, phone numbers, etc.
Obsessive-compulsive syndromes. The most common types are obsessive and phobic syndromes. Obsessive syndrome (without phobias) occurs in psychopathy, low-grade schizophrenia, and organic diseases of the brain. Phobic syndrome is represented mainly by a variety of obsessive fears. The most unusual and senseless fears may arise, but most often at the beginning of the disease there is a distinct monophobia, which gradually grows “like a snowball” with more and more new phobias. For example, cardiophobia is joined by agorophobia, claustophobia, thanatophobia, phobophobia, etc. Social phobias can be isolated for quite a long time.
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Nosophobia is the most common and diverse. cardiophobia, cancerophobia, AIDSphobia, alienophobia, etc. Phobias are accompanied by numerous somato-vegetative disorders. tachycardia, increased blood pressure, hyperhidrosis, persistent red dermographism, peristalsis and antiperistalsis, diarrhea, vomiting, etc. Motor rituals very quickly join in, in some cases turning into additional obsessive actions performed against the desire and will of the patient, and abstract obsessions become rituals .
- Phobic syndrome occurs in all forms of neuroses, schizophrenia, and organic diseases of the brain.
- Senestopathic-hypochondriacal syndromes.
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- For the neurotic level of the syndrome, the hypochondriacal component can only be represented by overvalued ideas or obsessions.
At the initial stage of development of the syndrome, numerous senestopathies occur in various parts of the body, accompanied by dull depressiveness, anxiety, and mild restlessness. Gradually, a monothematic overvalued idea of hypochondriacal content emerges and is formed on the basis of senestolations. Based on unpleasant, painful, extremely painful sensations and existing experience of communication, diagnosis and treatment, health workers develop judgment. using senestopathies and real circumstances to explain and form a pathological “concept of illness”, which occupies a significant place in the patient�s experiences and behavior and disorganizes mental activity. The place of overvalued ideas can be taken by obsessive doubts, fears regarding senesthopathy, with the rapid addition of obsessive fears and rituals.
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They are found in various forms of neuroses, sluggish schizophrenia, and organic diseases of the brain. With hypochondriacal personality development, sluggish schizophrenia, senestopathic disorders with hypochondriacal overvalued ideas are gradually transformed into paranoid (delusional) syndrome.