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[内源性躁狂妄想状态的精神病理学特征及夸大自尊妄想]

[Psychopathological features and delusion of exaggerated self-esteem in endogenous manic-delusion states].

作者信息

Sokolov A V

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(2):18-24.

Abstract

Forty patients with endogenous maniс-delusion states with the domination of exaggerated self-esteem in the clinical presentations were examined. Based on the analysis of mechanisms of delusion formation and congruency to the mania affect and its characteristics, 3 types of delusion syndromes have been singled out. Type 1 is characterized by the domination of delusion of exaggerated self-esteem, it is formatted by affective mechanisms as one of the symptoms of mania; type 2 is characterized by combined mechanisms of delusion formation (affective and acute delusion of sensuality - delusion of perception), with the domination of delusion of grandiosity congruent by its contest to mania affect. Type 3 is described by the formation of delusions according to mechanisms of acute paranoid state with paraphrenic-confabulatory modification congruent by the contest of affect to megalomaniac ideas of special mission, grandiosity, noble origin. All 3 types of maniс-delusion states differed by characteristics of mania affect, plot characteristics and a degree of delusion scope as well as features of depersonalization. Diagnostic wrongfulness of the orientation only on the contest aspect of delusion and greater predictive value of mechanisms of delusion formation are discussed.

摘要

对40例以内源性躁狂妄想状态为主且临床表现以自尊夸大为主的患者进行了检查。基于对妄想形成机制及其与躁狂情感及其特征的一致性分析,区分出了3种妄想综合征类型。1型以自尊夸大妄想为主导,它由情感机制形成,是躁狂的症状之一;2型以妄想形成的综合机制(情感和急性性感妄想——感知妄想)为特征,夸大妄想占主导,其内容与躁狂情感相符。3型的描述是,妄想根据急性偏执状态的机制形成,并伴有类偏狂性虚构性改变,其情感与特殊使命、夸大、高贵出身的夸大狂观念相符。所有3种躁狂妄想状态在躁狂情感特征、情节特征、妄想范围程度以及人格解体特征方面均有所不同。讨论了仅基于妄想的内容一致性方面进行诊断的错误性以及妄想形成机制的更大预测价值。

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