AFFECT PATHOLOGICAL

From Big Medical Encyclopedia

AFFECT PATHOLOGICAL - the short-term mental disorder which is expressed in a sudden attack of extraordinary strong anger or rage, arose in response to a mental injury. And. the item is followed by deep stupefaction, rough motive excitement with automatic actions and the subsequent amnesia.

The term «pathological affect» appeared in psychiatric literature in the second half of 19 century. Before there were names «angry unconsciousness», «insanity» which clinical contents to a certain extent corresponded to pathological affect. In 1868 R. Krafft-Ebing in the article «Painful Moods of Soul» suggested a condition of sharp sincere nervousness to call «pathological affect».

S. S. Korsakov emphasized forensic-psychiatric value of pathological affect, and V. P. Serbian delimited it from the physiological affect arising on the pathological soil.

Clinical picture

Development And. the item can be divided into three stages. In the first (preparatory) stage under the influence of the psychogenic injuring influence and the increasing affect consciousness concentrates on a narrow circle of the injuring experience.

In the second stage (a stage of explosion) there is an affective category which is shown in rough motive arousing, deep disturbance of consciousness, in disorder of orientation and speech incoherence. All this is followed by sharp reddening or blanching of the person, excessive gesticulation, an unusual mimicry.

The final stage is shown in sharply expressed mental and physical exhaustion. There comes the general slackness, slackness, indifference. Often there is a deep sleep. After awakening partial or full amnesia for a while is found And. item

Aetiology and pathogeny

Researches of an etiology and pathogeny And. items came down to clarification of a question of its dependence on the soil, on a cut it arises.

S. S. Korsakov considered that And. the item arises more often at psychopathic persons, however it can develop under the known circumstances and at persons without psychopathic constitution.

V. P. Serbsky wrote that And. the item cannot arise at quite healthy person.

It is necessary to assume that the lowered resilience of a brain concerning stressful influence promoting emergence And. to the item, a thicket happens at persons to nek-ry aberrations (psychopathies, traumatic damages of a brain, etc.). However under the influence of a number of factors (exhaustion after a disease, pregnancy, fatigue, sleeplessness, a hyponutrient, etc.) there can come the condition of the lowered resilience of a brain and at normal people.

During the short-term period of a current And. the item is not possible to conduct pathophysiological, biochemical and other researches.

The differential diagnosis

the Differential diagnosis should be carried out with physiological affect, with the affect arising on the pathological soil and with reaction of so-called short circuit [E. Kretschmer].

Unlike And. the item, physiological affect is not followed by change of consciousness, automatism of actions and the subsequent amnesia. At physiological affect there are no consecutive stages of its emergence and termination.

At physiological affect on the pathological soil the affective state reaches considerable degree and has the features inherent to affective reactions of the persons who had an injury of a skull, suffering from organic lesion of c. N of page, and also psychopathy. However these expressed and bright affective reactions are not followed by the described psychopathological phenomena (disorder of consciousness, automatism of actions, etc.) and their consecutive development.

At reaction of «short circuit» the affective category arises after long mental traumatization (long offenses, threats, humiliations, fear, need of to constrain constantly). In these cases affective impulses turn at patients directly into actions, being expressed in sudden acts, to it not inherent earlier.

Forecast

As And. the item is expressed only in short-term disorder of mental activity, a cut the forecast its favorable is an exclusive state. Shall go only persons at whom to an insane hospital And. the item developed on the pathological soil; at them it is necessary to carry out treatment of a basic disease.

In forensic-psychiatric practice And. the item is considered as the temporary disorder of mental activity excluding responsibility for the acts made in this state. The persons who made being able And. items dangerous acts, fall under action of the Art. II of UK RSFSR (or the relevant articles of the Criminal Code of other federal republics).

See also Nevmenyaemost .


Bibliography: Vvedensky I. N. A problem of exclusive states in forensic-psychiatric clinic, in book: Probl. sudebn. psikhiat., under the editorship of Ts. M. Feyn-berg, century 6, page 331, M., 1947; To and l and sh-N and to Ya. M. Pathological affect, in the same place, century 3, page 249, M., 1941; Korsakov S. S. Course of psychiatry, t. 1, page 239, M., 1901; Lunts D. R. Exclusive states, in book: Sudebn. psikhiat., under the editorship of G. V. Morozov, page 388, M., 1965; Serbian Century. Judicial psychopathology, century 1, M., 1895.

N. I. Felinekaya.

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