Hysterical depression. Hysterical Depression Clinic

Posted onOctober 14, 2019

Hysterical depression, a form of reactive psychosis, occurred in 22 patients. The relative rarity of the development of hysterical depression (among patients with hysterical reactive psychoses – 15.07%, in the total sample – 5.4%) is also confirmed by the data of N. E. Refsum and Ch. Astrup (1982) —7.9%. In the form of the outlined syndrome, this form of reactive psychosis preferably developed in patients with a hysteriform variant of psychopathic post-traumatic conditions. Its distinctive features were rudeness, exaggeration, elementarity and uniformity of clinical manifestations. The disorder of consciousness had a relatively “pure” psychogenic expression – there were no stunned phenomena in its structure. Depression is usually tearful. The affliction of melancholy is shallow, as a rule, is colored by traumatic irritability and does not correspond to its exaggerated pantomimic component: a pained expression on the face, wringing of hands, inconsolable tears or emphasized indifference, lethargy and helplessness. In the behavior of patients distinctly feature traits of pretentiousness, exactingness, often an aggressive attitude towards the environment. The ideas of self-accusation and the phenomenon of ideo-inhibition are not expressed. On the contrary, patients tend to blame others for everything, seek to justify themselves. Similar features were also noted by P. Faergeman (1963), N. E. Refsum and Ch. Astrup (1980). A characteristic clinical feature of hysterical depression developing on the basis of traumatic brain injury is an increased situational lability of the main mood and instability of the psychomotor background. These qualities are manifested in the tendency of patients to monotonous, acquiring the character of a stamp paroxysmally occurring rude hysterical reactions. Sometimes the excitement builds up and turns into a kind of hysterically depressive raptus with demonstrative suicidal attempts or superficial self-injuries. According to P. Faergeman (1963), N. E. Refsum and Ch. Astrup (1980), these symptoms indicate a shallow level of the course of the psychogenic reaction, indicating that only the most superficial layers of the personality are affected. As a rule, in connection with post-traumatic cerebral weakness, patients experience rapid exhaustion and such outbreaks result in short immobility, intense mutism or selective refusal to contact. Patients do not get out of bed for several days, tend to take cover with their heads in a blanket, they close their eyes when they turn to them, and pointedly do not take food. Their mood at this time is more noticeably colored by traumatic dysthymic layers, acquiring a particularly distinct irritantly vicious shade. In some cases, against this background, the statements of patients are delusional-persecutory in nature. People around are not only called the culprits of the plight of patients, but are also accused of having done it on purpose, in collusion with their ill-wishers, under the influence of the latter. Any systematization of these statements does not occur. When smoothing dysthymic disorders and increased asthenia, they quickly disintegrate, disappear or are replaced by a hypochondriacal plot. Against the background of aggravation of post-traumatic cerebral weakness (increased exhaustion, hyperesthesia, fatigue, affect lability), patients show unreasonable anxiety about their health condition, obsessively complain of headache, dizziness, get up out of bed with exaggerated labor, willingly accept the help of other patients, move around with visible effort, staggering, holding on to the wall, legs wide apart. The most caricatured form of the phenomenon of hysterical astasia – abasia is taken in patients with signs of intellectual decline in the structure of psychopathic syndromes. In some cases, a similar disorder of motility and statics is also found in the acute period of traumatic brain injury.

Leave a Reply

Your email address will not be published. Required fields are marked *