WEAK-MINDEDNESS (dementia; synonym dementia) — the permanent impoverishment and simplification of mental activity which is characterized by weakening of cognitive processes, depletion of emotions and a behavior disorder.
At S. intellectual activity is broken (see. Thinking ), especially its abstracting and integrating forms, the most difficult creative and critical abilities, the understanding of essential is lost, the available level of judgments decreases, stops or absolutely acquisition of new knowledge and skills stops, use of last experience extremely is at a loss and comes down to uniform repetition of usual judgments and actions, the level of mental activity decreases, specific features of the personality are leveled, emotional reactions become dull and grow coarse, adaptation abilities are broken, the behavior changes. At one patients slackness, decrease in motives (apathetic dementia) prevails, at others are expressed motive and speech disinhibition, edges is often combined with counterinhibition of the lowest inclinations. Thus, the general property of mental disturbances at S. allowing to combine them in a uniform psikhopatol. the syndrome, is the negative character of symptoms reflecting resistant damage of mental activity (see. Psychopathology ).
The page has difficult psikhopatol. structure. Ratio psikhopatol. the components making S.'s syndrome (disturbance of cognitive activity and change of the personality) can be various. The wedge, a picture C. is seldom exhausted by negative symptoms. More often S. develops in unity with various positive symptoms: affective and catatonic frustration, nonsense, hallucinations, etc.
Therefore at S.'s description allocate various wedge, forms. If the mental disease is shown by negative only symptoms, then this form C. call simple. So, simple S. is observed at any progressing mental disease — at general paralysis (see), senile dementia (see), etc. In some cases S. is combined with positive symptoms. In process of increase of decline of mental activity positive symptoms change: stereotipizirutsya and break up, napr, maniacal and depressions (see. Maniac-depressive psychosis ) there are monotonous and unproductive, catatonic frustration (see. Catatonic syndrome ) pass into a usual form of behavior, hallucinations turn pale. Similar modification of positive symptoms happens gradually and is most expressed in final stages of a mental disease.
The significant effect on formation a wedge, pictures C. renders age, napr, at senile age, irrespective of the nature patol. * process, S. gains a number of common features — so-called senile coloring. In one cases the gloomy and gloomy or dissatisfied and irritable mood, an aversion to surrounding, detachment is observed; in others — complacency, grumbling efficiency, cheerfulness with a shade of euphoria. Idiosyncrasy of S. developing in old age is safety of the automated reactions, usual forms of behavior, mimicry (see) and pantomimik, the taken most roots concepts and judgments at the accruing decline of mental activity.
Allocate S. inborn (see. Oligophrenias ) and acquired. Inborn S. represents the general, expressed in different degree mental retardation (an underdevelopment of mentality) caused by disturbance of early ontogenesis. It is shown in inability to abstract thinking and judgment of specific situations, limitation of stocks of knowledge and difficulty of their acquisition, an underdevelopment of the speech, weakness of memory and poverty of emotions. The created inborn S. represents rather stationary state, further deepening of insufficiency of mental activity is not peculiar to it.
The acquired S. results from usually progressing mental diseases. A uniform systematics of the acquired S. does not exist. For differentiation a wedge, types of the acquired S. various principles use. So, on nozol. allocate to a sign atherosclerotic (see. Atherosclerosis , Idiopathic hypertensia ), senile (see. Senile dementia), paralytic (see. A general paralysis), epileptic (see Epilepsy) and schizophrenic weak-mindedness (see Schizophrenia). However at various organic patol. processes S. similar psikhopatol meets. structures, and at the same disease — various forms C.
Depending on a current patol. process allocate the stationary and progressing weak-mindedness. Speak about stationary S. when forward development of a mental disease stops and the created S. does not go deep further. Allocate, e.g., stationary S. at a general paralysis — so-called stationary paralysis, to-ry can spontaneously come. Stationary S. can be observed at alcoholic encephalopathies (see) and some other mental diseases. At development patol. the processes causing S., already come S. continues to go deep (the progressing S.) and can reach a closing stage of disintegration of mental activity — a stage marasmus (see).
Depending on a wedge, manifestations allocate total and partial Page. Total S. (global, or diffusion S.) is shown by disturbance of the difficult and differentiated forms of cerebration, falloff of criticism and level of judgments (at rather smaller expressiveness of mnestichesky disturbances), deleting of specific features of the personality, impoverishment of emotional reactions with dominance of usually careless euphoria and counterinhibition of an inclination. Total S. is observed at a general paralysis, a disease of Peak (see. Peak disease ), Alzheimer's disease (see. Alzheimer disease ), etc.
Partial S. (dismnestichesky, or lacunary S.) is characterized by uneven or partial disturbance of mental activity. Its main signs — different types of easing of memory, frustration hronol. orientations at safety of orientation in surrounding and in own personality, slowness of mental processes, the decrease in mental activity which is combined with irritable weakness and an emotional incontience, decrease in level of judgments and criticism at safety of awareness of the insolvency, feeling of a disease and helplessness. Partial S. develops preferential at vascular diseases of a brain, syphilis of a brain and forms usually by gradual strengthening of negative frustration. A bit different type of partial S. is observed at acute disorders of cerebral circulation. In these cases in a wedge, disturbances of memory of type fixating are expressed to a picture amnesia (see), gross violations of orientation with the replacing confabulations (see. Konfabulez ). Sometimes such the wedge, a picture C. can be partially reversible. The page arising at organic lesions of a brain designate the term «organic dementia».
At damages of a brain are observed as well easier forms of weakening of mental activity which are not reaching degree of Page. Such states are called decrease in level of the personality. They are shown by permanent falling of mental activity, narrowing of a focus of interest, loss of the thinnest and differentiated personal installations and forms of behavior, sometimes emergence of increased fatigue and irritable weakness at rather small expressiveness of mnestichesky disturbances. Dynamics of these states is various and depends by nature basic disease; they go deep and reach S.'s degree at progreduated development of damage of a brain.
Treatment and the forecast are caused by a basic disease.
Bibliography: Dubinin A. M. Structural and dynamic understanding of dementia and its forensic-psychiatric value, in book: Court. - psikhiat. examination, her practician and a task, under the editorship of Ts. M. Faynberg, page 88, M., 1935; Snezhnevsky A. V. About senile dementia. (To a problem weak-mindedness and psychosis), Zhurn. neuropath, and psi-hiat., t. 18, No. 3, page 16, 1949; Shternberg E. Ya. Gerontological psychiatry, M., 1977; Scheller H. Uber den Begriff der Demenz und unterscheidbare klinische Formen von Demenzen, Nerven-arzt, Bd 36, S. 1, 1965; Zauter H. Demenz, in book: Lexikon d. Psychiat., hrsg. v. G. Muller, S. 94, B. u. a., 1973.
V. A. Kontseva.