Hysteria

Hysteria
Hysteria (Hysteria) Also called hysteria, it is psychonosema caused by obvious spiritual factor, implying or self-suggestion, mainly shown as feeling or movement obstacle, consciousness state change, symptom does not have a kind of neural disease on the organic foundation. Disease this exceed blue and green to have illness coming on mature stage, get up disease suddenly, can have numerous outbreak, saw more women particularly. The ill rate is 5 in the general population of the foreign report, the morbidity accounts for 50% of the neural disease of wartime in wartime, the one related to fighting wounded directly is about 40%- 60%. It is popular to study in the survey materials at home, regional report is widely different, account for the neural door of psychiatric department, 5%- 10% of total number of emergency calls. In recent years, the hysteria morbidity has the tendency to reduce. [The cause of disease and emergence of hysteria of pathogenesis ] relate to inherent cause, personality characteristics, briefly: On the basis of a certain personality, have illness coming on because of being traumatized, can also have illness coming on on the basis of body disease. A disease incidence is 1.7% - 7.3% that first, foreign materials of inherent cause show in the hysteria patient's close relative, it is taller than general residents. One women incidence 20% in the relative very much. Fujian area of our country reports the person who has positive family's history of a patient accounts for 24%. To brief on the inherent cause is even more important than the spiritual factor for some patients. Second, personality characteristic (1) High emotion: Mood is leant to inmaturely, apt to fluctuate, wilful, irritable and irascible, sensitive and suspicious at ordinary times, often lose the temper or cry because small to lock the thing. Emotional responses are too strong, it is apt to turn from one to another extreme extremely, often have overstating and dramatic color, it is easy to be emotional in nature to the thing to people. (2) High hint: Speech, action, attitude of accepting the people around easily,etc. influence to mean a patient very, and produced and called implying at the time of corresponding association and response; Some one's own at that time calls self-suggestion while feeling out of sorts and producing a certain corresponding association and response. The implying depends on the patient's emotion inclination, such as having emotion tendentiousness to some thing or someone, it is easy to be implied. (3) Height: Have inclination of people's self- centre, often flaunt and reveal excessively that controls oneself, like becoming the centre that everybody pays attention to. Mainly shown as and exaggerated symptom after being ill, pray for and sympathize with. (4) Abundant illusion: Imbued with illusion, the content of its illusion is vivid, apt to obscure realizing each other with illusion under the influence of intense emotion, leave the impression lying on somebody. Stress at above-mentioned four o'clock but the model person is called the attitude personality of venereal diseases of hysteria. The above-mentioned personality characteristics seem to stress after being ill further. Third, spiritual factor is generally stimulated by acute mental wound to cause more, can also be caused in painly by the lasting interpersonal contradiction or heart different to solve. Especially angry when can't give vent to grief, often cause the taking place suddenly of disease. Generally speaking, spiritual symptom is often caused by obvious and intense emotion factor, the intersection of body and symptom imply or self-suggestion cause, spiritual factor that have illness coming on for the first time have illness coming on form, the intersection of symptom and characteristic, course of disease and rotate to return determine often, more. And then spirit stimulates the intensity not big when sending, even does not have obvious reason objectively, because recall the past memories, experience and react in same intense emotion when being evoked and had illness coming on for the first time by Lenovo, and present symptom with similar mode and behave. Fourth, the body factor, when some body diseases or body states are not good, become the morbidity condition of hysteria because of being able to cause the cerebral cortex function to weaken. Such as cranium brain traumatism, acute generating heat disease, gestational period or menstrual period,etc.. Pathogenesis: The scholars explain from psychology, biology and physiologic different views. The psychological power school, according to inhibiting the principle, think that receives the ultra hope that I do not totally succeed in being constrained, take and disguise the form, through " change " Or turn into symptom. Pavlov will set out from physiologic view of the pathology of higher nervous activity to school, think the higher nervous activity (especially second signal system) of the hysteria patient Reduction,first signal system that be made it to regulate and control opposite to activity of the cortex disease position it strengthen or if you can't take off, inhibit, it is the physiological foundation of pathology that hysteria symptom takes place. " reflect " Say school think hysteria symptom essence one the intersection of nervous system and primitive, not instinctive response and this kind react, can continue person who send benefit strengthened, the but habituation of connection that or because the condition is diastaltic, become and melt and react voluntarily. The form of this kind of view is mainly based on the therapeutic experience of hysteria in wartime correctly, may not be suitable for the patient in peacetime. [The disease is relatively urgent that clinical manifestation ] arises, clinical manifestation is diversified. The person who regards body respect symptom as main clinical manifestation calls the changing type (Conversivetype) Hysteria; Regard respect symptom of spirit as the persons who mainly behave and call the separating type (dissociative type) Hysteria. First, clinical manifestation that the body symptom can demonstrate similar various nervous systems or viscera organ diseases, but lack the positive physical sign of the organic disease, symptom is shown as the excessive excitement of function of the organ or takes off the result lost. Common body symptom is as follows, (1) Feel the obstacle 1. Feel that takes off losing: Various simple feelings fail and disappear, there are many kinds of forms of expression, such as the whole body type, half a side type, paraplegia type, the glove or ankle socks type wait for, see more by half a side type, numb district and normal side demarcation line are clear, or is distributed along the centre line or abnormality, the explanation can't come with the organic disease law of nervous system. 2.Feel allergic: Such as irritation of sense of pain of skin, some some and violent and continuation pain of the body, it is apt to be acute abdomen by mistake if happen on the belly, even fasten by the unnecessary operation. 3.Special sense organ function obstacle: Breaking out deafness, visual field dwindle (in charge ofing visual field, is also called the partial view) , the amblyopia or losing one's sight, the sense of smell and obstacle of sense of taste,etc.. (2) Movement obstacle 1. Convulsion breaks out: Fall down to the ground slowly slowly while breaking out, it has no regularity that convulsion breaks out, four limbs are straight and upright, can't flex passively, or take the form of opisthotonos, or struggle to touch, pair holds the chest in hand, it is rich in the manifestation of emotion color to seize the hair, tear the clothes, roll, shout etc.. Complexion is flush while breaking out, one pair of eyes is closed, the eyeball moves about, the pupil is normal, reflect the existence to the light. Not generally breaking the tongue by the teeth or other and hurting urinary incontinence outside, can not find pathology at the same time. It lasts several ten minutes to break out for time. General consciousness is not totally lost, can remember partly after breaking out. 2.Tremble: Range but and head, tongue, limb, belly wall,etc., shake for popping thick abnormality, the scattering is lightened when being paid attention to. 3.Walking can't stand: A pair of lower extremities activity is normal while lying the location, the muscular strength is good, but Can't stand, unable to move even a single step. 4.Paralysed: It can be paraplegia, hemiplegia, one (or two, three, four) A limb is paralysed. Its skin is normal in tension and lowering or strengthening, often resist at the time of passive sports, without amyotrophy, the tendon reflects the existence, there are no pathology reflecting and the bladder, rectum sphincter function obstacle. 5.The aphonia is with speaking disease: Is low if whispers when the aphonia person speaks. No the spokesman insists on keeping silent in silence, but the ability of conversation by writing is intact. If called hysteria deaf-mutism while amalgamating deafness. (3) Reflect the obstacle: The tendon is reflected normally, actively or weakens, swallow areflexia occasionally. (4) Viscera function obstacle 1. Vomit: Mostly obstinate vomiting, vomit promptly after the food, it is disgusting not to have before vomiting, can still take food after vomiting, although vomit for a long time, it is malnutritive not to cause. Check the digestive tract, have corresponding positive discovery. 2.Hiccup: Hiccup breaks out obstinately, frequently, the sound is loud, particularly obvious when others pays attention to, lighten when being unmanned. 3.Excessively take a breath: Present and wheeze kind and breathe, though it is frequent and strong to break out, there are no cyanosis and oxygen deficiency sign. 4.Other: Hysteria ball, drinking more many urine, drum intestines,etc.. Second, spiritual symptom: Present more breaking outs. (1) Dim state: Narrowed the dimension of consciousness suddenly, could make and keep in touch and answer with the external world partly, speak content to be simple, often reflect the heart related to cause of disease experiences. Dual personality or ghosts and gods appear sometimes to enclose the body, there can be obviously vivid photism, illusion, the emotion is abundant and lifelike. Last from half an hour to 1- 2 hours, suddenly sober after signed, to going through in outbreak remember partlying or totally in order to remember. (2) The stiff state of wood: Get up disease suddenly, irritate reactionless to external world, a pair of upper limbs crooked the elbow and clenched fist, a pair of lower extremities were stretched, passive sports are resisted occasionally, the tendon is reflected normally, pathology is not reflected. Turn or move about at pairs of eye is closed, overturn the heavens the eyeball passively, the pupil is normal, react, store in to the light. Can with popping to get rid of angry, rhythm of the heart and normotensive. It can last several hours. (3) The emotion breaks out: Acute under spiritual factor function to have illness coming on, is shown as smiling, shouting, noisy, angry, speech of crying increases etc., often express heart to experience by way of singing ditty. Emotional responses are fast, smile through tears and with dramatic expression movements. Often there is influence of speech and attitude around to break out in duration. It is fuzzy that there is slight consciousness while breaking out, can remember partly after breaking out. (4) Spirit amnesia: With to cause the intersection of mental wound and limitation of incident forget, meet more, to promptly go through and forget, see hysteria while fighting all. (5) Fugue: The patient left home to go out to roam suddenly, lasts several days, can't remember to its course after waking up. [The course of disease present more breaking outs with prognosis ], the getting acute disease, disappear fast. Body symptom can present continuation, such as treating improperly, can last several years, even more than ten years, through treat while being appropriate, pleuripotent take a favorable turn rapidly, hysteria characteristic getting prominent personality, it is apt to recur. [Diagnose basis with differential diagnosis ] to must have person who get rid of and two basis of supporting etc. in rash of hysteria. So, must ask the medical history, process of developing of the symptom in details while diagnosing a disease and develop relevant factors with disease; Analyze the cause of symptom, properties and the characteristic conscientiously; Check body and essential auxiliary examination in detail, in order to get rid of other diseases; Especially children and it is middle-aged and old it present person who break out for the first time,or with when not coexisting some body diseases organic, should be cautious. Can't make diagnosis only on the basis that there is spiritual factor and suggest treating effectively before the disease, estimate spiritual factor and person who imply in each morbidity of patient, treat and transfer to, belong to, it has actual meanings to be very important objectively. Diagnose the basis: First, obvious spiritual factor and intense emotion caused by this are experienced. Second, production and disappearing and hint of symptom, self-suggestion maintains close ties. Third, getting acute disease, symptom is various. Check positive physical sign and evidence of organic disease not discovering and corresponding with body symptom. Spiritual symptom often has performance and exaggerative characteristic, there is distinct emotion color. Fourth, the intersection of personality and characteristic in front of the disease, namely similar history of breaking out, positive family's history and age and gender are very for referencial use. Fifth, get rid of brain and body organic disease, reactive psychosis, emotion obstacle and schizophrenia. [Hysteria of differential diagnosis ] displays very similar many kinds of diseases, do not distinguish, distinguish as follows only for example one by one: First, epilepsy break out big: Break out, unexpected consciousness lose, send out Xian call, fall down to the ground everywhere, first strong and frank one burst of contractions, clear by stages. The pupil breaks up big, reflect to the light that disappears, and there is a bunch of evidence of cone, duration is only 1 - several minutes, fall asleep after breaking out, wake up, totally forget. At the time of hysteria outbreak, consciousness is not totally lost, can remember partly after breaking out, fall down to the ground slowly, twitch law, duration long, and the intersection of cone and bunches of evidence,etc. can be distinguished. Second, reactive psychosis: Have similar history of breaking out, pathogenic spiritual factor strong, symptom react often emotion related to spiritual factor experience, it is easy to be implied, lacked distinct dramaticism, illusion and emotion too not to have like hysteria patient, there are few body symptoms. There are little persons who break out repeatedly. Third, schizophrenia: The enclosing the body of schizophrenia vainlies hope the content is absurd, duration is long. To enclose body, vainly hope for being popping, and expression vivid exposing by emotion hysteria, but schizophrenia inclines to conceal and does not discuss. Fourth, organic disease of the brain: Auxiliary examination results such as the dynamic observation of disease, detailed body and neural systems inspection and electroencephalogram, head CT,etc. can be distinguished. [Treatment ] one, psychotherapy: Because the patient asks anxious to treat, so the general support psychotherapy does not often gather the result. Usually rely mainly on implying or dredging letting out treating. After symptom is relieved, should explain the essence of disease to the patient in time, dispel misgivings, increase and treat confidence, should also point out: The patient's personality defect and relation having illness coming on, help the patient to find out and prevent and cure method,etc.. Second, drug therapy: The hysteria emotion breaks out to give sedative of enough dosage at one time; Convulsion break out, combine speech, imply the intersection of intravenous injection and 10% the intersection of glucose and sour calcium often; Select corresponding resisting the psychosis medicine to treat for use when spiritual symptom is obvious. Third, acupuncture and electricity are stimulated and treated: Suitable for hysteria paralysis or feeling obstacle,etc. and body symptom. After fourth, symptom are relieved, besides supporting to treat in psychology, should deal with remaining symptom to the ill. [Case ] woman, 19 years old, the student in Senior three. It is the only daughter, has grown delicately since the childhood Spoil, raise, roll about, act like a child in ground promptly while being unsatisfactory slightly. After growing up, everything regards her as the centre, otherwise keep silent for several days at home. , but good literature and art is intolerant, while rehearsing on the somth, criticized slightly, namely the sense is too winding to stand, bend over, pour in ground in a moment, consciousness unclear, pairs of eye close, loud to breathe, four limbs struggle the form is touched. Calm about one hour later, can't speak, but can answer with the pen, a pair of lower extremities take the form of paralysis. To the medical history of having no weight. Father healthy, mother emotional, often have " faint " irritate, while being every Phenomenon. Check: The bearing is proper, consciousness is still clear, hint there is mass since the underbelly rises to the larynx department with the gesture, chase form of breathing. Two lower extremities senses of pain disappear,
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