Neurosis Department of Pathophysiology Lecture presentation The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation  Department of Pathophysiology Neurosis Lecture presentation Professor Pirozhkov S.V. 2015-2016 education year

MODELING OF NEUROSIS WITH PREDOMINANCE OF INHIBITION ● Use of conditioned stimulus of extreme intensity ● Exposure to simultaneous effects of several strong stimuli ● Exposure to the effect of complex conditioned or unusual stimuli

MODELING OF NEUROSIS WITH PREDOMINANCE OF EXCITATION ● Undue delays in providing food reinforcement ● Complex discrimination tasks ● The need to develop several different discriminations in one experimental session

● Sudden change in the meaning of the conditioned stimulus MODELING OF NEUROSIS WITH A PATHOLOGICAL LABILITY OF THE MAIN NERVOUS PROCESSES (EXCITATION AND INHIBITION) ● Sudden change in the meaning of the conditioned stimulus ● Abrupt change of the habitual environment ● Collision of different reflexes (for example, alimentary and defensive)

Neurosis – ● typical form of disorder of the higher nervous functions ● that is potentially reversible ● caused by psychological stress and ● characterized by disorders of mood, emotions, behavior, mentation, and general decrease of well-being without degradation of a personality or loss of judgment ● often accompanied by autonomous symptoms and, in some types, by disorders of sensation and locomotion

FACTORS THAT FOSTER INADEQUATE ADAPTATION IN NEUROTIC CONFLICT ● Faulty upbringing ● Negative experiences in early childhood or formative years of life ● Personal traits ● Hereditary predisposition ● Unfavourable circumstances, hard conditions of life

THE CORRESPODENCE OF CLASSICAL NEUROSES TO MODERN NOSOLOGICAL FORMS ACCORDING TO ICD-10 F40. Phobic disorders (agoraphobia, social phobia etc.) F42. Obsessive-compulsive disorders F44. Dissociative (conversion) F45. Somatoform disorders F48.0. Neurasthenia Compulsion neurosis Hysteric neurosis Neurasthenia

DISSOCIATIVE (CONVERSION) DISORDERS Characteristic features: sudden, temporary alteration in the integrative functions of consciousness loss of memory or identity deficit of voluntary motor and sensory function these deficits are temporary, and not intentionally produced or simulated

SOMATIZATION DISORDER SOMATOFORM DISORDERS HYPOCHONDRIASIS SOMATIZATION DISORDER A belief of serious illness that persists despite reassurance and appropriate medical evaluation Preoccupation of a patient with somatic complaints with a focus more on specific symptoms rather than on fear of specific disease

Common phobias: ● Fear of closed spaces (claustrophobia) ● Fear of blood ● Fear of flying ● Social phobia ● Agoraphobia

Nucleus caudatum volume decrease Pathophysiology of obsessive-compulsive disorders Brain cortex Motor cortex Nucleus caudatum volume decrease Orbitofrontal cortex Alteration Nucleus caudatum Putamen Basal ganglia Globus pallidus Substantia nigra Brain stem Thalamus

Neurasthenia ● emphasis on fatigability and weakness ● concern about lowered mental and physical efficiency ● unpleasant feelings of dizziness, tension, headaches, general instability, irritability, anhedonia I type: ● complaint of increased fatigability after mental effort ● decrease in occupational performance or coping efficiency in daily tasks II type: ● emphasis on physical weakness and exhaustion after only minimal effort ● feeling of muscular aches and pain and inability to relax