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Post  counselor on Mon Oct 15, 2012 10:59 am


Elementary and secondary symptoms of schizophrenia Bleuler second, defined as detachment from reality, internalization of affect and prevalence of thought dereistico. For the Minkowski a., Demonstrating the loss of vital contact with reality, it would be the basic disturbance of schizophrenia. Is divided into rich and poor: the first is a rich productivity fantastic, so the patient would be folded into a private world, sometimes fueled by dispercezioni and delusions, in the second you would have a mental isolation deficient and would be typical of the chronic forms.

Infantile autism

Disorder that occurs before 3 years of age, characterized by a significantly abnormal or deficient development of social and communication and a markedly restricted repertoire of activities and interests (DSM-IV-R). Not dissimilar are the criteria adopted by the WHO classifies a. between the syndromes of global alteration of psychological development and underlines the inadequate understanding of the socio-emotional cues with little use of social cues and lack of socio-emotional reciprocity. There has always been considerable confusion in terminology with regard mental disorders peculiar to the first years of life. During the nineteenth century there was no distinction made between dementia, intellectual deficiency, and some severe character disorders, it was acknowledged that in some cases the onset of psychosis did go back to age child (Kraepelin, Bleuler), but was not isolated any particular form. It was first De Santis in 1906 to describe paintings of dementia precocious, that children are generally classified as oligophrenic, had however, a careful evaluation, many of the symptoms described by Kraepelin's dementia praecox in adults, such as mannerisms, stereotypies and symptoms Series catatonic. Potter in 1933 introduced the term childhood schizophrenia, whereas it is essential to diagnose the existence of a regression intellectual and affective needed, therefore, to an already partly organized and irrelevant to the early periods of life. Meanwhile, two main trends were taking shape and opposing the use of the expression childhood schizophrenia, the first restrictive, including in the framework only individuals without signs of cerebral disease, and extensive the second, which included several forms, including some on an organic basis. The controversy and the confusion led to the abolition of formula schizophrenia in psychiatry prepubertal childhood psychosis and the use of the expression by the authors in psychoanalytic approach. In 1942, Kanner described the first 15 cases studied by a. child, distinguishing it from childhood schizophrenia to the extreme isolation and detachment from the very first year of life. Autistic children often come to the observation with suspected blindness and deafness or because the parents appreciate the progressive isolation and specific behavioral manifestations that make them appear as encapsulated, locked in a fortress from which to watch the world empty without apparent affective component or intent to communicate. The diagnostic criteria from DSM-IV-R contain a qualitative impairment in social interaction that occurs with marked impairment in the use of various nonverbal behaviors (gestures, posture, facial expression, gaze) that regulate social interaction, inability to develop peer relationships appropriate to developmental level, lack of spontaneous seeking the condition of enjoyment, interests, or achievements with other people, lack of social and emotional reciprocity. There is also qualitative impairment in communication, as manifested by a delay or total lack of development of spoken language or marked impairment in the ability to initiate or sustain a conversation with others, use of stereotyped or idiosyncratic language, lack of varied, spontaneous make simulation games , or social imitative play appropriate to developmental level; patterns of behavior, interests and activities restricted, repetitive, and stereotyped, as manifested by an encompassing preoccupation with one or more stereotyped and restricted patterns of interest abnormal either in intensity or focus; submission Hard to specific, nonfunctional routines or rituals, stereotyped and repetitive motor mannerisms, and persistent preoccupation with parts of objects. In 75 cases 0ei coexisting mental retardation (usually moderate, with IQ 35-50), with possible abnormal development of cognitive abilities, which have an irregular profile. On physical examination can be detected several neurological signs such as primitive reflexes and delayed development of hand dominance, sometimes with a combination of neurological or other general medical base (percentages, according to the authors, from 5 0x1p-1537l 30) such as phenylketonuria, tuberous sclerosis, fragile X syndrome, anoxia at birth, maternal rubella, encephalitis). In 25 cases 665428ei Seizures may develop. The prevalence would be 2.5 cases per 10,000 patients with a male: female ratio of 3-4:1. The course rarely evolves into hallucinatory psychosis or delusional later. The language skills and overall intellectual level are the factors that most strongly influence the ultimate prognosis. In 1/3 of the cases it is possible to a certain degree of partial independence. For the most part the result is a form of psychopathy in postautistica in deficit, characterized by psychic infantilism and bizarre with poor social integration. In the original description by Kanner (1942) in the. syndrome was considered a purely psychogenic, but now you think that this is a very early psychotic mode of organization that can have variable pathogenesis and which also implied a defective primary component. The limitation of the subject's ability in recognizing the reality and external stimuli complex is linked to a lack of basic integrative CNS or to a defect in the experiences and early learning of the child. Besides the paintings already mentioned some organic-based, history provides, however, very often identifying fetal distress or neonatal implicated in determining the so-called minimal brain damages (minimal brain damage). The survey on neurotransmitter systems showed high levels of serotonin in whole blood, with abnormalities of the processes of uptake and platelet release correlated to the level of intelligence and age of the subjects, providing confirmation of the hypothesis of a maturational delay of the CNS. It would also highlighted an increase in homovanillic acid (metabolite of dopamine) in the cerebrospinal fluid of autistic, while the urinary levels of MHPG (major metabolite of norepinephrine) and catecholamine would be reduced compared to normal subjects. Studies on the immune system would have shown abnormalities in lymphocyte responses and immunological similarities between a. and virus diseases lenses and autoantibodies against the receptors of the 5-HT. Neurophysiological studies with evoked potentials show a deficit in the modulation of sensory input and the motor output to the trunk, allowing among other things, exclude blindness and deafness. Undesired operation of the mesocortical areas with close connections with the limbic system would, according to some theories, the basis of the dissociation between feelings and emotional signs. The a. seems to be at the convergence of multiple neurobiological and psychological factors that interact with each other. The possibility of a psychogenic origin has been carried out by various authors in reference to behavioral and psychoanalytic theories. The Kleinian and post-Kleinian stressed the primary role played by the mother figure that, in the case of an autistic child, would lose its function as an outer container of emotions. The child would be unable to metabolize the stimuli from inside and outside, experienced as threats to its integrity, and would implement complex defensive operations that would lead all'autoincapsulamento. The child would remain attached to the autistic phase (first 3 months), without reaching the stage of separation-individuation. The research to address cognitive deficits have identified a primary language, cognitive-linguistic. Other authors have pointed out the lack of the capacity to symbolize, but still did not find agreement on the existence of an alteration in primary and its identification. Meltzer (1989) and Tustin (1981) have emphasized the frequent presence of a postpartum depression in the mother. From the therapeutic point of view is often necessary to carry out preparatory work to psychotherapy with use of special techniques such as music therapy, therapies mediation body, speech therapy, family therapy and behavioral. Drug therapy, which uses mainly neuroleptics, is limited to decreases in anxiety and aggressive behavior.

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