歇斯底里症状复杂的更年期患者非心动性精神障碍的诊断和治疗问题(文献综述)

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Е. В. Лукьянова
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引用次数: 1

摘要

本文就绝经期女性癔症患者的非精神病性精神障碍诊断和治疗中存在的问题进行了探讨。心理治疗(PT)治疗NPMD、催眠治疗癔症(歇斯底里神经症、神经衰弱、强迫性神经症)的疗效。在NPMD的治疗中,创造性自我表达的PT是成功的。强调PT形成了患者对自己的自觉批判态度。结合PT与物理治疗歇斯底里的转换症状已被描述。在歇斯底里的表现中推荐使用抗精神病药,在神经性抑郁症中推荐使用轻度抗抑郁药。在严重的歇斯底里状态下,长期应用安定剂和抗精神病药物进行精神药物治疗。分离性和歇斯底里性疾病的稳定恢复已被证实。在植物血管结构紊乱的更年期综合征(CS)长春西汀,在精神情绪表现的phenibut给予。在治疗癔症时,应用“小效抗精神病药”、催眠暗示疗法、社会康复治疗。有效组PT治疗心因性条件障碍在衰弱性焦虑抑郁症状中是有效的。NPMD在癔症、衰弱性神经症、强迫性神经症中的综合治疗已被提出。组织专门的预防性检查,以早期发现有人格病理学的人。一些药物在围绝经期和绝经后的疗效- SSRIs和加巴喷丁,在更年期帕罗西汀,在非精神病性水平的抑郁症-吡嗪醇,coaxil,在神经性忧郁症-舒必利和喹硫平,地西泮,在更年期植物和精神障碍激素替代疗法(HRT),激素疗法,PPhT和PT,在CS的神经植物症状-抗抑郁药,在精神植物综合征- SSRIs,在心境障碍-天奈汀(coaxil),在对合性歇斯底里-精神药物和神经代谢作用药物,在轻度和中度精神情绪障碍-剥夺,在轻度和中等严重程度的抑郁症-缬doxan已被证明。在更年期抑郁症中,激素治疗可以阻止更年期症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ПРОБЛЕМНЫЕ ВОПРОСЫ ДИАГНОСТИКИ И ТЕРАПИИ НЕПСИХОТИЧЕСКИХ ПСИХИЧЕСКИХ РАССТРОЙСТВ У ПАЦИЕНТОК КЛИМАКТЕРИЧЕСКОГО ВОЗРАСТА С ИСТЕРИЧЕСКИМ СИМПТОМОКОМПЛЕКСОМ (ОБЗОР ЛИТЕРАТУРЫ)
In the article, problematic questions of diagnostics and therapy of non-psychotic mental disorders (NPMD) in female patients of climacteric age with hysterical symptom complex are considered. Efficacy of psychotherapy (PT) in NPMD, hypnopsychotherapy in hysterical states: hysterical neurosis, neurasthenia and obsessive-compulsive neurosis is indicated. In treatment of NPMD, PT by creative selfexpression is successfully used. It is highlighted that PT forms conscious-critical attitude of patients toward themselves. Combination of PT with physiotherapy in hysterical conversional symptoms has been described. In hysterical manifestations neuroleptics are recommended, in neurotic depressions – antidepressants of mild action. In severe hysterical state, psychopharmacotherapy (PPhT) with tranquilizers and neuroleptics is applied on long-term basis. Stable recovery in dissociative and hysterical disorders has been shown. In vegetovascular disorders in structure of climacteric syndrome (CS) vinpocetine, in psychoemotional manifestations phenibut was administered. In therapy of hysterical neurosis, “minor neuroleptics”, hypnosuggestive therapy, social rehabilitation were applied. Effective group PT of psychogenically conditioned disorders in asthenicand anxiety-depressive symptoms is effective. Complex therapy of NPMD in hysterical and asthenic neurosis, obsessive-compulsive neurosis has been suggested. Organization of specialized preventive examinations for early revealing of persons with personality pathology is based. Efficacy of a number of medications in periand post-menopause – SSRIs and gabapentin, during menopause paroxetine, in depressions of non-psychotic level – pyrazidol, coaxil, in neurotic hypochondriasis sulpiride and quetiapine, diazepam, in climacteric vegetative and mental disorders hormone replacement therapy (HRT), hormonal therapy, PPhT and PT, in neurovegetative symptoms of CS – antidepressants, in psychovegetative syndromes – SSRIs, in dysthymic disorders – tianeptine (coaxil), in involutional hysteria – psychotropic medications and medications of neurometabolic action, in psychoemotional disorders of mild and moderate degree – deprim, in depressive disorders of mild and mean severity – valdoxan has been shown. In climacteric depression, hormonal therapy stops climacteric symptoms.
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Byulleten Sibirskoy Meditsiny
Byulleten Sibirskoy Meditsiny MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
50.00%
发文量
102
审稿时长
8 weeks
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