| disease | Hysteria |
Hysteria, also known as hysterical neurosis, is a type of mental disorder caused by psychological factors such as major life events, inner conflicts, emotional agitation, suggestion, or self-suggestion acting on predisposed individuals. It primarily manifests as various somatic symptoms, narrowed consciousness, selective amnesia, or mental outbursts, but lacks corresponding organic damage as a pathological basis.
bubble_chart Diagnosis
I. Medical History and Symptoms
(1) This disease is more common in women, with obvious hysterical personality traits. The onset is often related to psychological factors, and there is a history of similar episodes in the past.
(2) The clinical manifestations are diverse. Based on the nature and form of symptoms, it can be divided into two types:
(1) Dissociative type:
Mainly characterized by psychiatric symptoms. ① Emotional outbursts, acute onset under the influence of psychological factors, manifesting as crying, laughing, rolling, shouting, etc. Emotional changes are rapid, often accompanied by dramatic expressions and movements.
② Narrowed consciousness, a twilight state where mental activity is confined to the unpleasant experiences that triggered the onset, with迟钝 perception and incomplete orientation. The duration is short, and most cases cannot recall the episode afterward.
③ Coma-like state, where the patient lies in bed with eyes closed all day, unresponsive to calls, eyes tightly shut. Examination may reveal eye回避, pupils not constricting. Other manifestations may include amnesia, alternating personality, Ganser syndrome, child-like dementia, and other psychiatric symptoms.
(2) Conversion type:Mainly characterized by physical功能障碍.运动, sensory, reflex, and autonomic神经功能障碍 may be observed. However, detailed examination reveals no corresponding organic basis, nor does it conform to the physiological characteristics of neuroanatomy. Common manifestations include痉挛发作, limb tremor, paralysis, inability to stand or walk, mutism and aphonia, sensory hypersensitivity, sensory减弱 or消失, hysterical球, and special sensory障碍, such as hysterical deafness, blindness, hysterical vomiting, hiccup, hyperventilation, and other autonomic神经功能障碍.
II. Physical Examination Findings:
No阳性神经 system损害 signs. Even if sensory or运动障碍 signs are present, they do not conform to the physiological characteristics of neuroanatomy.
III.辅助检查:
No阳性 findings corresponding to organic损害.
IV. Differential Diagnosis:
Should be differentiated from organic神经 system diseases such as epilepsy, multiple sclerosis, hepatolenticular degeneration, intracranial space-occupying lesions, etc.; psychiatric diseases such as schizophrenia, depression, reactive精神病, and personality disorders.
bubble_chart Treatment Measures
1. Psychotherapy:
Help patients correctly understand the disease, explain that it can be completely cured without leaving any disability, and work with the patient's family members, colleagues, and others to avoid the negative effects of tension or excessive concern caused by those around them.
① Suggestion therapy: This can be waking suggestion or hypnotic suggestion. The main approach is through verbal suggestion combined with appropriate physical therapy, acupuncture, or tuina to achieve therapeutic effects.
③ Behavioral therapy: Functional training for patients, suitable for cases where suggestion therapy is ineffective or where there are limb or speech impairments.
2. Drug Treatment:
For hysterical twilight states, psychotic states, or convulsive episodes where formal psychiatric treatment is difficult to administer, intramuscular injection of chlorpromazine hydrochloride 25–50mg or intravenous diazepam 10–20mg can be used to induce sleep. If psychiatric symptoms persist after the acute phase, oral chlorpromazine hydrochloride 25–50mg 1–3 times/day may be administered. For headaches and insomnia, alprazolam 0.4mg 3 times/day can be given.
