DYSPHORIA (grech, dysphoreo is heavy to transfer, suffer, be angry) — a special form of depressive frustration of mood, at a cut depression is combined with irritation, hostility, malignancy.
A clinical picture
Degree of manifestation of each of components D. and their ratio are with each other various. In the most mild cases the suppressed mood with uncertain concern accompanied with discontent, peevishness, fault-finding, in some cases irony or a causticity is noted. In more expressed and hard cases there is a melancholy, fear, despair, intense rage or frenzied rage. In one cases the changed affect, in others — various degrees of irritation and hostility prevails, but there is never a total absence of one of them. Motive frustration are frequent. At one patients block, others is observed, on the contrary, cannot find to themselves the place and are in the constant movement which is quite often reaching extent of psychomotor excitement (see. Excitement psychomotor ). Excitement at D. uniform, is more often silent, and in cases when it arises short flashes, is followed by pronouncing inarticulate sounds, shout. At availability of patients to communication they complain that it is difficult for them to think, concentrate that they badly understand what they are asked about. Quite often sad and spiteful mood is combined with expressed confusion (see)., arising at patients with organic diseases of c. the N of page, in particular in connection with the craniocereberal injuries postponed in the past, is followed by the expressed phenomena of the hyperesthesia reaching degree of a hyperpathia, and also various senesthopathias (see). When D. drags on for a week and more, somatic and vegetative disturbances are found: frustration of a dream, appetite — up to failure from food, weight loss, the general hyperhidrosis or, on the contrary, dryness of mucous membranes, tachycardia, fluctuations of level of the ABP.
At hard proceeding D. which are found first of all at epilepsy (epileptic D.) impulsive actions — self-damages, suicides or aggressive acts in relation to people around, a dromomania (impulsive vagrancy), a dipsomania (hard drinking true), sexual excesses are possible. In other cases there are crazy ideas of various contents, most often in the form of a crazy mood, the ideas of prosecution and hypochiondrial nonsense; the caused states are frequent affektivno twilight stupefaction (see). Occasionally D. can be replaced with short time by a condition of euphoria.
As a rule, D. begins suddenly and without external occasion. Much less often it is preceded by the adverse moments, is more often in the form of psychogenias (see. Reactive psychoses ), however discrepancy between an occasion and depth of mental disturbances is always noted., As a rule, proceeds hours, days, is more rare week and more. Terminates more often critically. The lytic termination is observed usually at long
the Diagnosis is made on the basis of listed a wedge, features. The differential diagnosis can be carried out with the so-called irascible manias which are found at schizophrenia, circular psychosis and some organic diseases of c. N of page, hebephrenic states (see. Hebephrenic syndrome ) with dominance of affect of rage.
At easy D. is on an outpatient basis applied by tranquilizers, neuroleptics (neyleptit, etc.), antidepressants (Triptizolum, etc.). Heavy D. are subject to hospitalization. In all cases treatment of a basic disease is necessary.
Forecast it is connected with a current of a basic disease. Is the frequent reason of dangerous actions.
Bibliography: Golodets R. G., the Kamensk V. M. and Afanasyev of Yu. I. Kliniko-elektroentsefalograficheskoye studying of dysphoric states at patients with epilepsy. Zhurn, neuropath, and psikhiat., t. 72, No. 2, page 233, 1972, bibliogr.; Gorbunova-Posadova N. I. Clinic and forensic-psychiatric value of dysphoric states at traumatic damage of the central nervous system, in book: Probl, court. psikhiat., under the editorship of G. V. Morozov, Saturday. And, page 81, M., 1961; About r d about in and T. N. The remote period of the closed craniocereberal injury in forensic-psychiatric aspect, M., 1973, bibliogr.; Gurevichm. O. Psikhiatriya, M., 1949, bibliogr.; S with h and-fetter of Ch. Allgemeine Psychopatholo-gie, S. 216, Stuttgart, 1976.
H. G. Shumsky.