PSEUDO-DEMENTIVE SYNDROME

From Big Medical Encyclopedia

PSEUDO-DEMENTIVE SYNDROME (Greek pseudes false + lat. dementia madness, madness; syndrome:; synonym pseudodementia) — a psychopathological state with the passing regress of mental activity imitating weak-mindedness.

The item of page meets at hysterical reactive psychoses (see. Reactive psychoses), being a form or one of stages of their development. It is more often observed at men.

For a wedge, pictures P. of page suddenly arising decline of mental activity which is shown the wrong answers (mimorech) and actions (mimodeystviye) is characteristic as if. Patients are not guided in surrounding (do not know where they are, cannot correctly designate current month, year), incorrectly answer the simplest questions, with appreciable errors perform elementary tasks (on a request to show eyes patients thumb a nose, instead of a hand — a leg; the shoe is put on hands, in sleeves of a dressing gown push legs, try to light a match the return end, etc.). However their answers always correspond to a subject of the question posed; e.g., white color they call black, summer — in the winter, a window — a door, on a question how many on a hand of fingers or how many eyes, the patient can answer that it has 4 fingers, 5 eyes. Disturbances of reading, and also the letter — agrammatisms, admissions of letters, roughness of handwriting are observed (see. Letter ). Outward of patients is characteristic — they are lost, stare, on a face a senseless smile.

Allocate two a wedge, option P. of page: agitated and depressive. The agitated P. of page. develops sharply and proceeds against the background of psychomotor excitement. Patients are fussy, restless, it is difficult to draw their attention. They make many unnecessary movements, without need touch surrounding objects, finger clothes, grimace, wriggle. Euphoria inadequate to a situation which is easily replaced by tension with alarm and fear prevails. The speech is accelerated, answer sore points without delay. Answers are usually directly opposite on sense. The symptom of the wrong actions is typical. Hysterical narrowing of consciousness is noted (see. Hysteria ).

Depressive P. of page. develops gradually against the background of psychomotor block. Mood of patients alarming suppressed. They sit in a mournful pose with widely opened eyes, silently cry, are lost, timidly look around. Their thinking is slowed down; answer questions after numerous repetition, answers have character of denial («I do not know», «forgot», «I do not remember») or perseverations (the answer to one of questions repeats also at the subsequent questions). The symptom of the wrong actions at depressive option has the erased, rudimentary character. So, at a request to give the left hand of the patient long considers both hands, then raises one, another and, at last, stretches one of hands;

The Item of page can define entirely a wedge, a picture of reactive psychosis, is quite often combined with symptoms of a puerilism (see). During the deepening of a disease the agitated option P. of page often is replaced by a puerilism, depressive — a psychogenic stupor (see. Reactive psychoses ). The item of page lasts usually of 2 weeks up to 3 months. Sometimes P. page is accepted by a long current, a picture at the same time monotonous, uniform and flows against the background of a substupor. Memories of disease state at patients or completely are absent (especially at the page agitated with P.), or are sketchy (everything occurred as though in a dream).

Diagnosis establish a wedge, pictures on the basis. Differential diagnosis is carried out with a mimogovoreniye (mimorechyyu) at schizophrenia (see), with organic weak-mindedness (see) with the phenomena of aphasia (see) and apraxias (see), and also simulation (see). Mimorech at schizophrenia it is combined with catatonic symptoms (see. Catatonic syndrome); the wrong answers of patients with P. of page always correspond to a subject of the question posed; also P.'s communication by the village with the psychoinjuring situation is characteristic. Otgranicheny organic dementia with the phenomena of aphasia from the anamnestic pseudo-aphasia observed at P. by page is based that the last is only a stage of transformation of a symptom of the wrong answers at involution of P. of page. Isolation of symptomatology, absence complete a wedge, pictures P. of page and its typical dynamics is characteristic of simulation.

Treatment it is carried out by psychotropic drugs in combination with psychotherapy (see).

Forecast for life favorable.


Bibliography: Gulyamov M. G. Some new data in the doctrine on a pseudodementia, in book: Probl. court. psikhiat., under the editorship of G. V. Morozov, Saturday. 8, page 144, M., 1959; Judicial psychiatry, under the editorship of G. V. Morozov, page 307, M., 1978; Felinskaya N. I. Reactive states in forensic-psychiatric clinic, page 76, M., 1968.

I. N. Bobrova.

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