CONFUSION in psychiatry (synonym andffekt bewilderment) — painful misunderstanding by the patient of the state and surrounding, to-rye are realized as unusual, inexplicable, causing bewilderment. The first mentioning of R. occurs at T. Meynert (1880), Confusion as independent psikhopatol. frustration was allocated by K. Vernike.
The river is the symptom testimonial of existence of psychosis and about sharpness psikhopatol. states. R.'s manifestations depend on a stage of development of psychosis and on features psikhopatol. frustration, to-rykh it enters into structure. When mental activity is disturbed superficially, consciousness of the izmenennost remains, and also the reflection is noted, there is R., to-ruyu call initial. At the same time consciousness of the «I» remains. The first signs of initial R., as a rule, are found at inquiry of patients, to-rye state bewilderment concerning singularity of the health. To them it is unclear what happens to them, but they give the report on singularity of the state. Trying to describe it, they use such expressions: «I do not understand what is with me!», «In me something changed», «Probably, I go crazy». Patients correctly describe the events around, but it is realized by them as unclear. At this time external signs of R. are insignificant (e.g., expression of bewilderment on a face). Such R. can arise at the beginning of development of depressive syndromes and various psychoses. At further development of a mental disorder of R. changes. Bewilderment amplifies, it is shown not only in a look, a look and statements of the patient, but also in features of his behavior. The events which are taking place around are unusual, full of mysteriousness that causes intense bewilderment. At the same time there is nek-paradise a confidence in a certain maintenance of made. Patients begin to state various assumptions of sense of the events. At this time they have no crazy ideas yet, they only speculate about value unclear, unsolved. Such type of R. belongs to initial R.'s kind and accompanies the initial stages of development figurative nonsense (see).
In further R. it can be noted at all types of figurative nonsense, the nek-ry agitated depressive syndromes and it is designated as crazy R. Soznaniye of own izmenennost at patients at the same time is absent. Crazy R.'s intensity depends on precipitancy of development of an acute delirium, hallucinatory confusion, oneiric frustration. At increase of weight psikhopatol. states external manifestations of crazy R. amplify and become in a wedge, a picture prevailing. When the acute figurative delirium passes in grezopodobny, fantastic, R. is shown in all appearance of the patient, at the same time puzzled statements are minimized. At oneiric syndrome (see) R. exists until patients are capable to perceive surrounding. When consciousness is completely filled grezopodobny images, R. is replaced by a condition of so-called load, a cut is shown by concentration on the sick images which gushed and filled consciousness, feelings. Load at the first stages of the development can be combined with separate manifestations of River.
R.'s presence in a wedge, a picture of a mental disease demands acute medical assistance.
Bibliography: Kerbikov O. V., etc. Psychiatry, page 64, M., 1968; Jaspers K. Allgemeine Psychopathologie, V., 1973; Meynert T. Amentia, die Verwirthelt, Wien, 1880; R i t t e of of M. R. u. To 1 e i s t K. Psychosen der Ratlosig-keit, Arch. Psychiat. Nervenkr., Bd 195, S. 163,1956; Storring G. E. Wesen und Bedeutung des Symptoms der Ratlo-sigkeit bei psychischen Erkrankungen, Lpz., 1939; Wernicke C. Grundriss der Psychiatrie in klinischen Vorlesungen, Lpz., 1906.
H. Ya. Belenkaya.