From Big Medical Encyclopedia

NOSTALGIA (grech, nostos return + algos suffering, pain) — the form of a reactive state arising at persons whose bonds with the homeland are interrupted in whole or in part; it is shown by the mental and physical disorders inherent first of all to depressions.

Most often at N. there are masked depressions, hypothymic and various on symptomatology (see. Depressive syndromes ). As well as at situational depressions (see. Reactive psychoses ) at their contents there is a leading injuring moment of loss, in this case losses of the homeland and the past, a cut thanks to ability of the person to forget bad and to remember good is always recalled in an idyllic form and opposed to the burdensome present. In more hard cases precordial melancholy, the ideas of self-accusation, the motive disturbances inherent to the developed depressions can join initial superficial depressive frustration. Sometimes there are pictures of the agitated depression or a depression with confusion of consciousness. Peters (U. Peters, 1971) allocates three stages in development of heavy nostalgic depressions. In the first stage fatigue, depression, an otgorozhennost with constant return to thoughts of Rhodinum prevails, about to-rykh do not speak to people around; in the second — thoughts of Rhodinum dominate over all others and are the only subject of a talk, at the same time are interrupted a sleep, appetite, patients grow thin, working capacity them decreases; in the third stage against the background of the expressed melancholy there are crazy ideas, confusion of consciousness and if not to begin treatment, death is possible.

Nostalgic depressions sometimes are the reason of development alcoholism (see) and drug addiction (see), suicides, aggressive actions, arsons, murders, to-rye can have impulsive character (see. Impulsive inclinations ). So, at the beginning of 20 century murders of children by the young domestic servants who arrived to others country were often observed.

At N. crazy states, cardiovascular diseases, a peptic ulcer of a stomach, and also decrease in the general body resistance, deterioration in a current hron, diseases are possible.

N.'s development and degree of its intensity are caused by a combination of external and internal factors. Carry to external factors: a rupture of contacts — primary (with a family), secondary (with friends), tertiary (from a sotsialnsha of an in-tama); degree of contrast in situations before and after a gap; influence of a gap on the purposes pursued by an individual in a profession and the device of life; possibilities of communication with family members, with former friends, with a new environment; existence or lack of a language barrier; relation to an individual of a new environment and faces of a former environment; uncertainty of the future; reversibility or irreversibility of a gap; memorials (holidays, birthdays of relatives, anniversaries), under influence to-rykh the N amplifies.

Internal factors are mental and physical condition; age (elderly people are most vulnerable); vital installations and system of values, in particular the relation to property (in capitalist about-ve property quite often has bigger value, than related attachments, and loss of property can promote N.'s development); education level (poorly educated individuals are more vulnerable); social opportunities; a sex (in similar situations of N. appears at women easier that is connected with their frequent social isolation in the conditions of the capitalist countries). The listed factors demonstrate to what in N.'s development the importance not only loss of the past, but also degree of adaptation to new living conditions has.

Most often N. develops at the emigrants who forever left the homeland; at the working capitalist countries forced to live for years owing to poverty in others countries; at soldiers and prisoners during war, and also at soldiers in peace time; at being in exile and sentenced to imprisonment, especially on long terms; at old men and chronically sick.

Diagnosis N establish a wedge, pictures on the basis of the anamnesis and features. The differential diagnosis is carried out first of all with states, similar to N., arising at schizophrenia (see) and is much more rare at maniac-depressive psychosis (see).

Treatment: psychotherapy usually in combination with psychotropic drugs. The positive take, though not in all cases, gives return of an individual to conditions of former life.

The N in some cases can have serious social and medical effects. Especially it concerns the military contingents, at to-rykh N. can accept character of mental epidemic (see. the Induced insanity ).

According to Tsvingmann (Ch. Zwing-mann, 1973), at a large number an amer. the soldiers who were taken prisoner during military invasion of the USA into Korea the expressed N.'s manifestations developed: prisoners lay on a floor, having taken cover with the head a blanket, refused food and through short time died. Death was observed at 38% of prisoners. The commission on investigation of circumstances of death of captured soldiers created by the president Eisenhower took out the conclusion that they were in rather good conditions. Poro (A. Porot, 1969) also gives examples of the death of captured soldiers from the general exhaustion which developed at N. Timely repatriation of prisoners almost always leads to bystry recovery.

Bibliography: Peters U. H. Worterbuch der Psychiatrie und medizinischen Psycho-logie, S. 303, Miinchen, 1971; Porot A. Manuel alphabetique de psychiatrie, p. 411, P., 1969; Zwingmann Ch. Pfister-Ammende M. Uprooting and after, p. 19, 142, N. Y., 1973.

H. G. Shumsky.