From Big Medical Encyclopedia

MANIACAL SYNDROMES (fr. maniacal, from grech, mania madness, a sincere disease; a syndrome) — the states which are characterized by painful increase in mood, acceleration and simplification of associative processes and excessive aspiration to activity; arise during various mental diseases.

The clinical picture

M.'s Intensity of page can be expressed in various degree. In mild cases a little raised background of mood, the increased working capacity is noted. Patients feel feeling of the general wellbeing and satisfaction, surrounding gets iridescent shades (a hypomaniacal state) in their consciousness.

Excessive gaiety, extreme variability of attention, superficiality of judgments and estimates, the optimistic relation to the present and the future are characteristic of more hard cases. Patients reside in fine mood, do not get tired, feel inflow of forces and extraordinary cheerfulness.

Change of associative processes affects along with acceleration of rate of thinking in variability of attention, a sharpening of memory (hypermnesia). Patients are extremely verbose, the speech their hasty, they talk without a stop. Quite often «the gallop of the ideas» — sharp acceleration of thinking develops, at Krom continuous change of one unfinished thought by another is observed. The inconsistency, inconsistency of statements reaching sometimes full incoherence are possible. Everything that occurs around, both essential, and insignificant, draws attention of the patient, without lingering, however, on anything a long time. In some cases this variability of attention gains so intensive character that the patient fixes a look and comments on everything that gets to the field of his sight (supervariability of attention, or a symptom of a hypermetamorphosis across Vernika).

The increased aspiration to activity is shown at patients differently: one are accepted to a lot of cases and do not finish any of them, others randomly, thoughtlessly, and often and ridiculously spend money, buying unnecessary things, the third begin to interfere actively with working process of the enterprise where they work, suggesting to change its structure radically. Quite often patients leave work, for days on end visit the acquaintances and relatives, creating around themselves vanity and a disorder.

To page revaluation of own personality is inherent to subject M.: they find in themselves uncommon abilities, express a persistent desire to change a profession, consider that they have talents of the statesman, the writer, the artist, the actor, the scientist, and sometimes and give themselves for those. Are frequent, especially at women, the idea of erotic contents: they consider that they are an object of attention and desire of persons of an opposite sex. The listed ideas of revaluation of the personality (or the ideas of greatness) differ in extreme instability and variability.

Maniacal patients look looked younger, they have a live and expressive mimicry, the increased appetite, the increased sexuality, also persistent sleeplessness or considerable reduction of duration of a dream, increase of pulse, excessive salivation, the speeded-up urination are noted. At women the menstrual cycle is, as a rule, broken.

Depending on psychopathological features simple and difficult options M. of page are allocated.

The unproductive mania, the confused mania and an irascible mania belong to simple options.

An unproductive (inactive) mania — a maniacal state with dominance of the increased mood and lack of aspiration to activity. Acceleration of associative processes in these cases is expressed unsharply.

The confused mania — a state, at Krom into the forefront acts sharp acceleration of associative processes that results in incoherence of thinking, confusion of thoughts.

In an irascible mania irritability, fault-finding, irascibility, in some cases — aggression prevail.

Carry maniacal states at which in structure of a mania develop nonsense of a performance, acute fantastic delirium (see to difficult options of a syndrome. Nonsense ), oneiroid (see. Oneiric syndrome ), catatonic frustration (see. Catatonic syndrome ). Perhaps also development of hallucinations, pseudohallucinations, phenomena of mental automatism.

In some cases in M.'s structure of page there can be frustration at first sight not compatible to a picture of a state: senesthopathias (see), hypochiondrial nonsense and even suicide tendencies.

The diagnosis

the Diagnosis of a maniacal state is based on characteristic of M. of page to a triad of frustration. Differentsialno - diagnostic criteria of M. of page within various nosological forms are based as on presence at structure of a syndrome of the symptomatology testimonial of an endogenous or exogenous origin of a disease, and on features of a psychopathological picture of a state.

Etiology. Most often M. of page develop at endogenous diseases (maniac-depressive psychosis, schizophrenia), and also can be a consequence of symptomatic and organic diseases of a brain (e.g., a craniocereberal injury, a general paralysis, etc.), to arise during epilepsy.

Treatment it is carried out by neuroleptics (aminazine, Triphtazinum, Stelazinum, majeptil, a haloperidol), salts of lithium.

Forecast concerning life favorable, concerning working capacity p social adaptation depends first of all on a nosological form, within a cut the described syndrome, and also from depth and expressiveness of the changes of the personality connected with development of a basic disease developed.

In a maniacal state in connection with the raised background of mood, aspiration to activity and intellectual excitement acts of the patient can have antisocial character; concerning the acts incriminated to the patient patients usually admit deranged.

Prevention consists in careful overseeing by the patient during the period between attacks, purpose of small doses of antipsychotic drugs in case of development of unsharply expressed affective frustration, use of drugs of lithium.

See also Excitement psychomotor .

Bibliography: Iovchuk H. M. Depressive and maniacal states at children and teenagers, Zhurn, a neuropath, and psikhiat., t. 76, No. 6, page 922, 1976, bibliogr.; L at-komsky I. I. Maniac-depressive psychosis, M., 1968, bibliogr.; it e, Current state and perspectives of studying of maniac-depressive psychosis, Zhurn, neuropath, and psikhiat., t. 71, No. 11, page 1719, 1971, bibliogr.; Nul-l e r Yu. L. Some pathogenetic mechanisms and classification of maniac-depressive psychosis, there she, t. 76, No. 5, page 717, 1976, bibliogr.; Arieti S. Manic-depressive psychosis, in book: Amer, handbook psychiat., ed. by S. Arieti, v. 1, p. 419, N. Y., 1959, bibliogr.; K e of of of T. And., Schapi raK.a. Rot h M. The relationship between premature death and affective disorders, Brit. J. Psychiat., v. 115, p. 1277, 1969; M a g g s R. Treatment of manic illness with lithium carbonate, ibid., v. 109, p. 56, 1963; New dimensions in psychiatry, ed. by S. Arieti a. G. Chrzanowski, p. 3, N. Y., 1975.

A.S. Tiganov.