There is a large group of mental disorders, referred to in the clinic as "borderline states" (functional, i.e., fundamentally reversible mental pathology). This group includes neuroses, neurosis-like states, some types of depressive disorders, psychosomatic states, acquired forms of psychopathy, etc. 25. Question: Tell us about neuroses.

Borderline neuropsychiatric disorders, among which neuroses occupy a significant place, firmly hold a leading position in a wide group of mental illnesses. According to the World Health Organization, about 10% of the population of industrialized countries suffer from neuroses, and over the past 65 years, their number has increased 24 times. The incidence of neuroses in Russia is 20-25 people per 1000 population.

This is only the recorded incidence and, rather, it can be considered as the tip of the iceberg. Neuroses, like an epidemic, are spreading everywhere. It is known that from 30 to 65% of visitors to general practitioners are people with pronounced neurotic symptoms. There is a sad joke among specialists who study this pathology: instead of asking whether a person suffers from neurosis, it is necessary to ask what kind of neurosis he suffers from.

In the last decade, the problems associated with the origin of neuroses have begun to be actively reconsidered. The attitude towards this disease as a mild mental dysfunction is changing significantly. The principle of functionality (easy reversibility) is not confirmed by modern clinical practice. According to data published in the press, recovery from neuroses occurs in less than 40-50% of patients.

It has been established that only 10% of patients recover in the first three years of the disease. Often the suffering lasts for years and even decades. According to the definition adopted in our country, neurosis is a psychogenic (arising on a nervous basis) neuropsychiatric disorder, which is formed as a result of a violation of especially significant life relations of a person.

Simply put, neurosis develops when a person, due to various circumstances, cannot find a suitable way out of a difficult situation, resolve a psychologically significant situation or endure some tragedy. 26. Question: List the main symptoms of neuroses. The symptoms of a neurotic breakdown are well-known: low mood, irritability, insomnia, a feeling of internal discomfort, lethargy, apathy, loss of appetite.

All these symptoms are accompanied by general malaise, unpleasant bodily sensations, and vegetative disorders. Manifestations of neuroses can be generally referred to as a stable loss of mental peace. In neurosis, a person retains clear criticism, is burdened by his condition, but cannot help himself.

At the same time, there are also conditions that clinically resemble neuroses, but develop according to a different mechanism. They are defined as neurosis-like and occur in many somatic diseases, infectious processes, atherosclerosis of the cerebral vessels and other pathological processes. In addition, a neurosis-like clinical picture can often be found in people with a bad character or significant shortcomings in upbringing.

The term "neurosis" has become firmly established in our life and is unknown only to an infant. There are school and retirement neuroses, neuroses of achievement and loneliness, somatogenic and ecological, as well as many other varieties of this ailment. A special group consists of the so-called noogenic neuroses associated with the loss or absence of the meaning of life in a person, value conflicts.

There is evidence that approximately every fifth neurotic case has a noogenic basis, but in reality it seems that almost every neurosis has spiritual roots. 27. Question: Who and when first introduced the term "neurosis"? The concept of "neurosis" was first proposed in 1776 by the Scottish doctor Cullen, and since then discussions about the essence of this disease, the roots of its occurrence and the mechanisms of its formation have not ceased to be less vital.

However, this does not mean, of course, that neuroses did not exist at all before Cullen; their appearance, as well as the appearance of diseases in general, occurred as a result of the fall of man. The description of neuroses is already found in the most ancient written sources of mankind. For example, the Kahun (c. 1900 B.C.) and Ebers (c. 1700 B.C.) papyri contain data on the morbid states of women, which are very reminiscent of the clinic of hysterical neurosis. 28.

Question: There are different interpretations of the concept of "neurosis". How to understand the views on this disease? Today it is difficult to find another concept in medicine, interpreted by various scientific schools so ambiguously and even contradictory. Neurotic reactions that can arise in a person after severe shocks, conflicts, somatic diseases or life troubles are very diverse.

Their symptoms are superimposed on the personality of a person, the features of his character - hence the polarity of views on this problem. At the forefront of scientific discussions are not only the issues of the systematics of neuroses, but also their very existence as a nosological (painful) form. The extreme point of view of some psychiatrists looks something like this: neurosis is normal behavior in an abnormal society.

Other opinions can be presented as follows: brain dysfunction; repression of internal conflict into the unconscious; uncompromising attitudes and dogmatic way of thinking; inability to predict a conflict and prepare for it; incorrect stereotypes of behavior, etc. Some researchers attribute the origins of neuroses to the peculiarities of human thinking, others to the pathology of emotions, still others to a violation of the process of self-knowledge, and still others to psychological immaturity and infantilism.