Neurosis mainly refers to a group of mental disorders with certain common features: the onset is mostly related to qualities, personality traits or mental stress, and patients have reduced mental activity; mental distress with anxiety and worry or various somatic complaints; corresponding organic changes cannot be detected on physical examination; they know they have a disease and seek medical attention from many sources; they generally have no or no persistent psychotic symptoms; their ability to test reality is not impaired; their behavior generally remains Behavior is generally within the range of social norms, and can be understood and accepted by others. The course of the illness is often prolonged or episodic.
From a psychological point of view, neurosis is precisely a psychological conflict: it is mainly manifested by a persistent psychological conflict; the patient perceives or experiences this conflict and is deeply distressed by it, and it impedes psychological or social functioning; but there is no verifiable organic pathological basis, specifically the following five common features
1. Psychological conflict.
Patients with neurological disorders perceive themselves to be in a paradoxical psychological state that they are unable to extricate themselves from, such as anxiety, persistent tension, fear, nagging worries, irritability, meaningless ruminations, and obsessive-compulsive ideas. The patient knows that this psychology is abnormal, but cannot control it. As a result, the patient is always in a state of conflict.
2. Mental pain.
Patients subjectively feel very painful, even painful, pessimistic and desperate, often seek medical advice, like to find psychologists, often looking for people to complain, talk about their condition, hoping to get sympathy and understanding, eager for treatment, so some people say “no mental pain, it is not neurosis”.
3. Persistent course of the disease.
The psychiatric disorders of neurosis are more persistent, except for hysteria, most neurosis start slowly, gradually aggravated, sometimes episodic, and often untreated, so that patients lose confidence in treatment, the current treatment can control anxiety and depression as soon as possible, the course of the disease is expected to be shortened, such as improper rehabilitation treatment, easy to relapse, resulting in a protracted course of illness.
4, impaired psychosocial function.
Because the psychological conflict of neurosis, often fixed, so that patients do not see hope, or the content of the psychological conflict is variable, often in several things in life back and forth in a circle, often so that the two opposing sides of the psychological conflict reinforced each other, forming a vicious circle, increasingly serious hindrance to the patient’s psychosocial function.
5. No verifiable organic lesion as the basis.
Some psychological conflicts are caused by organic pathologies.
In fact, there is no evidence to date of organic disease in neurotic patients, and it is difficult to detect the pathological basis of neurosis in various tests.
Usually neurosis can be divided into.
1. anxiety neurosis.
Divided into panic attacks and generalized anxiety, with anxiety as the main manifestation: for no clear objective object and specific content of the nervousness, fear, fearful and anxious mood, often accompanied by vegetative symptoms and walking fidgeting
2. Obsessive-compulsive neurosis.
Can be divided into compulsive ideas, compulsive actions, compulsive intentions, compulsive behavior
3, phobic neurosis.
Also divided into place phobia, social phobia, object phobia and other phobias, mainly manifested as strong terror of certain objects or situations, and the degree of terror is not proportional to the actual danger. Often avoidance behavior, they know that excessive, but can not control.
4, hypochondriacal neurosis.
The main manifestation is the persistent fear or belief that they are suffering from one or more serious physical disease preoccupation concept, the patient everywhere to tell the physical symptoms, repeatedly go to the doctor, but all kinds of tests are normal but still can not eliminate the patient’s doubts, often accompanied by severe anxiety, depression
5, neurasthenia and other neurological disorders.
Neurosis is manifested as easy mental excitement and mental fatigue, mood tension, worry and irritability, sleep disorders, muscle tension pain, decreased work efficiency, etc.
Depressive neurosis is now classified as an affective disorder; dysthymia is in a separate category.
The prevalence of neurosis accounts for 2.2% of the social population, and 22.21‰ of the population aged 15-59. In psychiatric outpatient clinics in general hospitals, neurosis accounts for 63%. The prognosis of neurosis is generally good, but the prognosis of obsessive-compulsive disorder is poor.
Diagnosis of neurosis.
Since neurosis is a group of mental disorders that share many common features but are divided into several disorders, each with its own characteristics, the diagnosis of neurosis should be considered from several aspects. First of all, according to the medical history, is there a reason for the onset of the disease; what are the personality characteristics of the patient; is there a physical disease; do the characteristics of the mental disorder have the common features of neurosis; which neurosis does the clinical manifestation mainly conform to? Usually the doctor, on the basis of detailed medical history, does some necessary clinical examination to exclude organic diseases, and also does some psychological tests, such as the Minnesota Personality Test. After carefully conducting psychiatric examination, the doctor carefully analyzes the above collected data and finally makes a diagnosis with reference to the classification and diagnostic criteria of mental disorders.
Differential diagnosis.
Mainly and the simple type of schizophrenia, or the early stage of the onset: the main points are the different duration of the disease, the different introspection, the possibility of psychotic symptoms such as hallucinations and delusions, the absence of incoherent symptoms, and understandable symptom content.
The treatment of neurosis is summarized in three areas.
1.Psychotherapy
Including general psychological counseling, supportive psychotherapy and specialized psychotherapy, such as psychological guidance, comprehension therapy, psychoanalytic therapy, behavioral therapy, hypnotherapy, rational emotion therapy, cognitive therapy, biofeedback therapy, Morita therapy, etc.
2.Medication
Such as antidepressants: tricyclic amytriptyline, tetracyclic maprotiline, selective pentazocine inhibitor fluoxetine, etc.; anti-anxiety, such as clonazepam, alprazolam; antipsychotics, such as chlorpromazine, fenadine, Vistone and other drugs such as sulpiride, insulin, etc.
3. Rehabilitation treatment
Including rehabilitation training, improve social adaptation, improve psychological immunity, etc. On how to treat a certain neurosis, depending on the specific situation, it is generally said that under the guidance of a doctor, choose several appropriate methods to combine treatment, the effect is better. If a patient with generalized anxiety, anti-anxiety and antidepressant is necessary, psychotherapy is also the basis of treatment, with a combination of psychological and drug, the efficacy is better than a single method.