Search

Paranoid and hallucination syndromes were studied in 71 cases of senile non-dementia psychoses located at the patients' house. Two major variants were singled out: paranoid and hallucinatory (the latter subdivided into patterns with or without the persecution delusion, and physical affection delusion). Paranoid variant was shown to be based upon a special transformation of visual perception with formation of delusions of penetration of a "stranger" into the patients' home. Hallucinatory variants were based predominantly on primitive physically-straining hallucinations with protopathic meaning. As the paranoid syndrome increased in severity, the space of its projection onto housing place expanded. It is suggested that housing conditions themselves could influence the psychopathology of housing paranoid.

A total of 84 senile patients with malignant schizophrenia were examined. These pateints could be divided into 3 groups: with adolescent schizophrenia (with an onset of the disease before 24 years); with schizophrenia in middle age (with an onset of the disease from 25--35 years); with late schizophrenia (with an onset from 40--61 years). It was established, that the clinical and age-associated differences between the groups are distinct only in the initial and manifest stages of the disease. In the terminal period of the disease seen in senescence, there is a complete smoothening of the specific traits of each group, which is due to a formation of a deep defect infrequently associated with pseudosenile traits.

On the basis of a study of 51 patients with schizophrenia older than 60 years of age with catatonic outcome states the author accomplished differentiation of these conditiones with consideration of the character of the catatonic symptoms, as well as of the whole structure of the state. It was demonstrated that in the elderly the most diverse of the described in literature catatonic outcome states may be encountered. A significant percentage of the studied cases was with outcome states, prevalence of speech disorders and certain restoration of adaptation.

Selective attention was studied by registering cortical evoked potentials to acoustic stimuli in mental patients and mentally healthy subjects of old age. Disorder of selective attention in the patients was manifested in an impaired ability of the higher portions of the central nervous system to differentiate between essential and non-essential external stimuli as well as in a weakened inhibition of irrelevant information.

On the basis of examining 86 senile schizophrenics with defective initial conditions two groups of such conditions were specified: 1) defect conditions retaining the structure specific for schizophrenia (apathic defect, apathic mental deficiency and its variant with pseudosenile disturbances); 2) defect conditions, approaching by their manifestations to the picture of psychic disintegration associated with senile dementia. The psychopathological structure of the first group of defect conditions primarily reflects the degree of the schizophrenia progression. Their time course in old age was limited to insignificant age-related modifications and decompensation. Deficit conditions in the second group develop the more frequently, the closer to old age the period of the maximum activity of the schizophrenic process and the older the patients.

On the basis of a study of 217 patients with terminal schizophrenic states in old age the author found it possible to distinguish 2 forms of such conditions: psychotic and deficient. The psychotic forms were expressed in syndromological polymorphic psychoses, which most frequently reflected the form of the process development and which is senescence often enough undergone pathoplastical changes. The deficiency forms were presented by apathic dementia, while the connection with the previous form of development was lost. In many cases in old age there was worsening of the states with a senile-like change of the clinical picture.

Ecmnestic disturbances were revealed in 170 out of 260 schizophrenic patients who have lived up to the old age. In all the patients the disease took an unfavourable course (paranoid and malignant schizophrenia). The ecmnestic disturbances appeared to be rather diverse in their contents, and were encountered in the structure of various psychopathological manifestations both productive and deficient. Two types of the ecmnestic disturbances were differentiated, and namely, ecmnesia of delay and ecmnesia of regression of the psychic development. The role of the age factor in the formation of each type of those disturbances is demonstrated.

The authors investigated the impact of single CT investigation of senile dementia patients. CT was assessed visually. Investigated were 214 patients (23 with senile dementia, 29 with Alzheimer disease, 14 with Pick disease, 90 with vasculogenic dementia, 58 with other forms of dementia). The overall high efficiency of CT was shown in diagnosis of senile dementia. Depending on peculiar clinico-morphological relations different patterns of CT contribution to dementia diagnosis are determined: its verification, detection of concomitant (clinically latent) pathology, establishment of an alternative diagnosis, reduction of the number of diagnostic hypotheses, correction of a diagnostic error.

Under examination there were 100 patients with paranoid schizophrenia who had reached an old age. In all the patients signs of delusion reduction were observed at the late stages of the disease. It was shown that most delusional disorders tended to transform into residual ones and to become peculiar manifestations of the derangement. Against this background it was actual delusional experiences that persisted most frequently. More and more place in their structure took psychopathological elements that reflected various aspects of the ageing of the patients' psychosis.

The authors studied 62 patients with late schizophrenia with the predominance of elementary misperceptions. The main variants of such psychoses with auditory, olfactory and tactile perceptive disturbances have been identified. The authors also ascertained common typological signs distinguishing these psychoses from the classical paranoids of late age. A possible role of the age and environmental factors in the formation of the above psychoses is considered.

Thirty-eight patients with late mentally deteriorating processes were studied. Using a standardized neuropsychological method, the authors have outlined four major variants of neuropsychological syndromes characteristic of damage to definite zones of the brain. Comparison of these data with the results of clinical and computer-aided tomographic examination showed that the neuropsychological approach is an adequate method in the combined study of senile dementia.