Diagnosis of neurotic and somatoform disorders

The signs of a neurotic disorder are variable and imprecise; each person’s neurosis can manifest itself differently. Therefore, in order to accurately establish a diagnosis and receive adequate treatment, you need to consult a psychotherapist.

Important

A psychotherapist diagnoses neurosis. The treatment regimen that will help cope with the disorder depends on the type of neurosis and its severity.

Neurosis is a functional disease of the nervous system. This means that the disorder occurs temporarily; there is no infection, tumor, or persistent pathology of blood vessels or internal organs in the body. Negative factors deplete the nervous system:

• stress;
• overvoltage;
• internal conflict;
• traumatic situation.

This causes disturbances in the functioning of the heart and blood vessels, indigestion, strange pain and discomfort in different parts of the body. Somatologists (who deal with diseases of the body - therapists, neurologists) do not find any abnormalities: neither peptic ulcers, nor abnormalities of the endocrine system (for example, the thyroid gland), nor inflammation.

Manifestations of neurosis in adults are often confused with other diseases, so most patients undergo examinations for years, but treatment does not produce results. In such cases, it is recommended to consult a psychotherapist.

The body is healthy with neurosis, most tests are normal. “All diseases come from nerves” - that’s exactly what it’s about.

How to recognize neurosis? It is characterized by the following symptoms:

• somatic manifestations (from the body) - vague pain, increased fatigue, changes in blood pressure, fever, sweating;
• emotional instability - frequent unreasonable or causeless anxiety, fear, irritability, tearfulness;
• poor load tolerance - a person cannot concentrate, sometimes cannot sit still. Both work and personal life suffer; basic tasks become tiresome very quickly.

In the next part we will take a closer look at how neurosis manifests itself and what specific symptoms and complaints are possible.

What is VSD

Vegetovascular dystonia (VSD), or neurocirculatory syndrome, is a functional disorder of the autonomic nervous system, in which a complex of symptoms appears that are not characteristic of a specific disease. Examination of patients with suspected VSD most often does not reveal changes in the structure of internal organs, but may show deviations in their function at the border of normal.

Autonomic dysfunction cannot be called a full-fledged disease; this diagnosis is not included in the International Classification of Diseases (ICD-10). But therapists, cardiologists and neurologists continue to make this diagnosis to patients in whom the examination did not reveal any disorders, and complaints of poor health continue.

It is believed that manifestations of pathology arise due to disturbances in the coordination of the two structures of the autonomic nervous system. It consists of the sympathetic and parasympathetic systems, which differ in their effects on the body. The activator of sympathy is the hormone adrenaline, so it performs the following functions:

• increases the number of heart contractions;
• increases blood pressure;
• stimulates the release of glucose into the blood;
• dilates the arteries of the brain, lungs and heart;
• reduces saliva secretion;
• suppresses peristalsis of the digestive tract;
• dilates the bronchi and enhances gas exchange;
• enlarges pupils;
• causes spasm of the sphincters of the bladder and digestive tract.

These reactions are necessary to protect the body in a dangerous situation, to activate it to escape. The parasympathetic nervous system works in the opposite direction. It reduces blood pressure, accelerates peristalsis of the intestines and urinary organs, and constricts the pupils and bronchi. The parasympathetic activator is the substance acetylcholine. It slows down the heartbeat, reduces blood glucose levels and relaxes all the sphincters in the body.

Autonomic dystonia occurs when the sympathetic or parasympathetic system is activated spontaneously, for no apparent reason. Therefore, a person suddenly has an increased heartbeat while at rest, his blood pressure rises, and he is worried about anxiety.

But often vegetative-vascular dystonia is a precursor to serious diseases. Having arisen at a young age without treatment, after a few years it leads to the formation of arterial hypertension, heart disease, digestive tract and hormonal disorders.

Literature

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Causes and symptoms of VSD

Adolescents and women are at risk for developing vegetative-vascular dystonia. In men, VSD rarely occurs as an independent syndrome; dystonia is usually associated with other diseases. The causes of the pathology are most often unknown, but its appearance is associated with the following provoking factors:

• stress – constant nervous tension causes the release of stress hormones, which stimulate the autonomic nervous system;
• hormonal changes - physiologically in women during the menstrual cycle, with the onset of pregnancy, menopause, the concentration of sex steroids changes, which indirectly affect the functioning of the nervous system;
• maturation of the nervous system – in adolescents leads to pronounced signs of VSD;
• bad habits - smoking, drinking alcohol, caffeinated drinks cause disturbances in the functioning of blood vessels and the conduction of nerve impulses.

The first symptoms of vegetative dystonia may appear in childhood. They are associated with heredity and characteristics of pregnancy. If the expectant mother suffers from vegetative-vascular dystonia, smokes, and has been diagnosed with arterial hypertension, then the risk of pathology in the child increases significantly. The health of the baby is negatively affected by intrauterine hypoxia, disruption of feto-placental blood flow, as well as the stress experienced by the pregnant woman. Acute fetal hypoxia during childbirth can also lead to the formation of VSD at an early age.

The formation of vegetative-vascular dystonia in adults can be associated with osteochondrosis, head injuries, and poor nutrition. Prolonged life in poor environmental conditions and work in hazardous industries also leads to VSD. Weather-dependent people also often experience dystonia.

Symptoms of autonomic dysfunction are varied; doctors identify more than 40 signs of the disease, but not all of them occur in one patient. Usually this is a combination of 4-5 constant symptoms and several additional ones. Depending on the manifestations of the cardiovascular system, there are three types of vegetative-vascular dystonia:

• cardiac - not accompanied by pressure surges, it is characterized by pain in the heart area or interruptions in its work;
• hypertensive type - a person suffers from high blood pressure, which is accompanied by panic attacks, chills, and increased physical activity;
• hypotensive type – characterized by low blood pressure, which is maintained at 100/50-90/45 mm Hg. Additional concerns include weakness, drowsiness, and dizziness.

Signs of dystonia include periodic shortness of breath, a feeling of shortness of breath, or a sensation of spasm in the throat. Many people complain to the doctor about pain in the heart, a feeling of increased heartbeat, pressure in the chest, interruptions in the heart, but it is rarely possible to record them using an ECG. Symptoms of autonomic dysfunction include decreased appetite, heartburn, flatulence and other digestive disorders. The disease manifests itself in the form of frequent urination or urinary retention, chills and cold extremities, and increased sweating. Many people complain of weather sensitivity, sleep disturbances, mood swings and irritability. In women with VSD, the menstrual cycle may be disrupted or symptoms of premenstrual syndrome may appear 1-2 weeks before menstruation.

The severity of signs of vegetative-vascular dystonia may vary. Depending on the frequency of symptoms, the following types of disease are distinguished:

• paroxysmal – attacks of vegetative-vascular dystonia periodically appear;
• permanent - the symptoms of dystonia are constant, usually mild, but can intensify under the influence of provoking factors;
• mixed - includes characteristics of the two previous types;
• latent type - signs of the disease appear only after severe stress, the rest of the time the symptoms do not bother.

Vegetative-vascular dystonia, if prolonged without treatment, can lead to disturbances in the functioning of the heart. People who are overweight, eat poorly, and suffer from physical inactivity have an increased risk of developing coronary heart disease and hypertension. In women aged 45-50 years, VSD aggravates the course of menopause.

Stages of schizophrenia

Psychiatrists distinguish 3 stages of the development of the disease.

1. Mastery

The initial stage, which is characterized by a constant feeling of anxiety. Most often, the patient does not understand where it came from. The occurrence of obsessive thoughts leads to the fact that the patient constantly checks whether he has turned off the gas, locked the apartment, and turned off the iron. With the help of timely drug therapy, unpleasant symptoms are eliminated.

1. addictive

The middle stage of development of the disease, which is accompanied by changes in the personality and consciousness of the patient. The real or fictional world is intertwined with each other, a schizophrenic cannot understand where is truth and where is fiction. The feeling of fear goes away over time, the patient perceives the current state of affairs as a given. This stage requires immediate treatment in a hospital.

1. Regression

This is a severe stage of the development of schizophrenia, during which profound changes in a person’s emotional background are observed. The patient does not react in any way to surrounding events and people; he loses feelings of joy, sadness, shame and pleasure. The condition resembles dementia or dementia in old age. Logical thinking is completely absent, speech and motor functions are impaired. This stage is difficult to treat; to maintain the patient’s vital functions, medications are used to restore neural connections in the brain.

Diagnostic methods

Vegetative-vascular dystonia is an exception diagnosis. This means that it is placed after a complete examination of the cardiovascular and nervous systems, if no abnormalities are found in them.

For diagnosis, you need to contact a general practitioner, who, if necessary, will refer you to a cardiologist, neurologist or endocrinologist. In order for a doctor to make an accurate diagnosis, it is necessary to accurately describe the symptoms and the time of their onset. The therapist will definitely clarify whether the patient drinks alcohol, nicotine, how often he drinks coffee and what daily routine he follows. This data is necessary to correctly make recommendations for the treatment of the disease.

To diagnose vegetative-vascular dystonia, the following methods are used:

• laboratory diagnostics - general blood and urine analysis without specific changes, in biochemical analysis the lipid ratio may be disturbed;
• blood test for hormones - a study of thyroid hormones is indicative; if they increase, tachycardia and weight loss may be observed;
• ECG - changes are not typical for VSD, sometimes it is possible to record tachycardia, single extrasystoles, but there are no signs of severe conduction disturbances in the heart;
• EEG - electroencephalogram can reveal slight deviations in the conduction of impulses in the brain;
• Ultrasound of internal organs - examination of the abdominal cavity in case of complaints of indigestion, examination of the heart, kidneys, and pelvic organs in women.

Dysfunction of the nervous system is not accompanied by damage to internal organs; most indicators are within the normal range, despite complaints of poor health.

Sluggish schizophrenia

The diagnosis of sluggish schizophrenia is considered mild; it is a mild form of the disease. It does not imply critical changes in a person’s character and his brain. Clinical symptoms increase very slowly, and the patient exhibits a complex of signs of neurotic disorders. This form of the disease is characterized by obsessive-compulsive disorder, various phobias, hypochondria, and paranoia.

Common symptoms:

• autism;
• scarcity of interests;
• selfishness;
• difficulties in contacts with others;
• the occurrence of hysterical attacks against a background of increased anxiety;
• suspicion.

Patients often experience causeless pessimism, which has no basis in real life. Many psychotherapist patients talk about attacks of sentimentality that they had never had before, self-doubt, and various fears. Often this condition is attributed to nervous tension and stress, but in fact it is a hidden symptom of a mental disorder.

Where is schizophrenia treated in Moscow?

At the acute stage, the patient should be in the hospital. In this state, he cannot control himself and his actions and requires round-the-clock care and the use of medications.

The Clinic of Dr. Isaev treats schizophrenia using safe, licensed drugs. The disease goes into remission, he can continue to live normally and take care of himself on his own.