From Big Medical Encyclopedia

IMPULSIVE INCLINATIONS — the insuperable motivation to commission of these or those actions which is completely seizing mind with simultaneous suppression of any other aspirations, representations, desires. At developed And. century the explanation of motives of acts is absent.

Originally And. were considered as manifestations of the isolated defeat of instincts century that was the cause for their allocation in the independent disease called by Zh. Eskirol (1838) instinctive monomania. In the middle of 19 century. And. century under the name «instinctive insanity» were considered by V. Manyan (1892) as one of mental signs (stigmata) of a degeneration. The main sign combining in a uniform concept of frustration of inclinations began to consider the sign of impulsiveness which is characterized by «suddenness», precipitancy with the subsequent incomplete and inconsistent reminiscence of the acts when the person follows an inclination of a painful rush without anything to that an occasion and does not understand what does and for what does. Therefore after the concept «instinctive insanity» the concept «impulsive insanity» succeeded. At the beginning of 20 century it was established, as. represent not a separate painful form century, and only a syndrome which can arise at the most various mental diseases.

Clinical picture

And. meet in the form of vagrancy century (a dromomania, a poriomania, vagabondazh), commission of arsons (pyromania), theft (kleptomania), hard drinking (dipsomania); to And. century some cases belong sexual perversions (see) in the form of a sadism, masochism, homosexuality, pedophilia, a geronthophilia, exhibitionism and some other states.

In one cases there is only one some look And. century, in others their various forms coexist. So, the dromomania can be combined with a dipsomania, a pyromania with kleptomania, etc.

And. can suddenly develop century, without any harbingers, or emergence them is preceded by the period of uncertain concern estimated for hours, days and even weeks with impossibility to perform usual work, there is a suppressed mood which is combined in some cases with alarm, irritation or hostility to people around (see. Dysphoria ). In some cases consciousness at the same time can be filled with representations which content reflects this or that form I. century. During an initial stage there can be the known fight of motives and only then there is a performance And. century. At height And. century affective narrowing of consciousness can be observed.

Termination I. can suddenly occur century; in some cases transition to a usual state happens lytically. Reminiscence of contents And. century always to some extent incomplete and inconsistent. Often the persons who made the action caused And. century, have the feeling of sharp simplification which is combined with a condition of mental and physical weakness. Quite often And. repeats in a stereotypic form century.

Impulsive vagrancy — pristupoobrazno the arising uncontrollable need for change of a usual situation which is carried out by all means — on foot, with use of different types of accidental transport. Patients throw everything, without deliberating effects. Lack of appliances is not an obstacle for implementation of an inclination. Movement on foot can be made until there comes the state physical. exhaustion.

Impulsive arsons — commission various by the sizes and effects of arsons. Patients can undertake various precautionary measures not to be caught, but quite often such measures are naive. One of them with detachment from everything and block are entirely absorbed by contemplation of a show of the fire and the situation of vanity, alarm, panic arising at its suppression, others are directly involved in fight against fire. Affect is usually increased, is followed by curiosity, enthusiasm and even ecstasy.

Impulsive theft is shown in the form of the thefts deprived of the mercenary purposes. In this regard patients steal accidental, quite often absolutely unnecessary things which then either are put, or lose, or distribute. In some cases patients steal the things which are for them fetishes (see. Sexual perversions ), and in these cases for possession of a desirable subject they can show big dexterity, the sequence in actions, an ingenuity. K I. century some cases of the writing of anonymous letters, statements, purchase of unnecessary things, pathological passion can be to a certain extent carried — the totalizator, gamblings, etc.

the Pathogeny

the Pathogeny is unknown. Apparently, for And. century existence of a disgarmonichesky warehouse of the personality matters. Mechanism I. try to explain from positions patholologically of the fixed conditioned reflexes century.

The diagnosis

the Diagnosis is made on the basis of set a wedge, signs. And. meets at the most various diseases century: schizophrenia (see), epilepsies (see), general paralysis (see), organic diseases of c, various on genesis. N of page, oligophrenias (see) and psychopathies (see).

At inertly proceeding diseases with psychopatholike changes of the personality I. develop century more often than at conditions of the expressed intellectual decrease or manifest psychoses. In cases of inertly proceeding mental diseases and psychopathies insuperable And. century fight of motives can precede for some period.

And. it is necessary to distinguish from impulsive actions century. Impulsive actions — rather simple motive acts, acts which arise and are made by patients suddenly, without fight of motives, without their weighing, without comprehension. The most frequent example are impulsive actions of patients with catatonic frustration (see. Catatonic syndrome ). Impulsive actions are made also in a condition of the melancholic raptus (which is suddenly arising during a depression of sad excitement with aspiration to suicide, self-damage) or under the influence of the crazy ideas (see. Nonsense ). Distinguishes them from And. century, in addition to external shapes of manifestations, existence of manifest symptoms of psychosis. And. it is necessary to differentiate with persuasive inclinations century (see. Persuasive states ). The last are followed by constant internal fight and are not implemented in action.

Treatment and prevention depend on a basic disease.

Forecast it is connected with features of that disease, against the background of to-rogo develops And. century

Forensic-psychiatric assessment

Persons, at which And. arise against the background of psychosis or inertly proceeding mental disease, tending to a progrediyentnost, i.e. deepening of personal changes century, are deranged. Also persons with the expressed intellectual decrease — inborn (oligophrenia) or acquired admit deranged (various organic diseases of c. N of page). Persons with a psychopathic warehouse of character and with easy intellectual changes usually admit responsible.

Bibliography: Vasilyeva L. P. Frustration of inclinations (group of so-called pyromanias) at psychopathic persons and their forensic-psychiatric assessment, in book: Vopr. court. psikhiat., page 13, M., 1969; Gannushkin P. B. Clinic of psychopathies, their statics, dynamics, systematics, M., 1933; Korsakov S. S. Course of psychiatry, t. 1 — 2, M., 1901; Krechmer E. Medical psychology, the lane with it., M., 1927, bibliogr.; Serbian V. P. Judicial psychopathology, century 2, M., 1900; Handbuch der forensischen Psychiatrie, hrsg. v. H. Goppinger u. a., B. — N. Y., 1972; Jaspers K. Psychologie der Weltanschauun-gen, B., 1960; M a g n a n Y. Psychiatri-sche Yorlesungen, Hft 1 — 4, Lpz., 1891 — 1893.

And. K. Kachayev.