Type therapy
schizophrenia
Etiology:
The cause of schizophrenia is unknown and has obvious genetic tendency. Both parents are schizophrenics, and the prevalence rate of their children is 39.2%. In addition, factors such as metabolism and psychological environment are also closely related to its onset.
Symptoms:
(1) The patient's thinking is confused, with rich associations but no logic;
(2) Emotional disorder and narrow tolerance;
(3) gradually showing indifference and lack of response to the outside world;
(4) Introversion, indulging in his own fantasy world and being divorced from reality;
(5) Hallucinations, mainly auditory hallucinations (70%), hallucinations of touch, smell and taste, hallucinations are rare, and delusions.
Treatment:
Mainly treated with drugs. Commonly used drugs are phenothiazine (chlorpromazine, trifluoperazine, piperazine, etc. ), thioanthracene (Telden), butyl benzene (fluorohydrin, trifluoroethanolamine, etc. ), Rauvolfia (reserpine) and others such as sumpiride.
The principle of treatment is sufficient, sufficient course of treatment, reduction after the attack is completely controlled, and finding the lowest effective maintenance dose, the same below.
Emotional psychosis/disorder
Etiology:
Emotional psychosis is related to genetic and neuroendocrine factors.
Symptoms:
(1) The typical symptoms of mania are high mood, wandering thoughts and psychomotor excitement, and sometimes rage and aggressive behavior. There may also be inattention, exaggerated delusions, and occasional association disorders;
(2) The typical symptoms of depression are depression, decreased speech and slow action. Patients may have symptoms such as fatigue, drowsiness, decreased libido, anxiety, insomnia, paranoia and guilt. Sometimes there are suicidal thoughts and behaviors, and this emotional expression often lasts for more than 10 weeks;
(3) Mania can appear alternately with depression, which is bipolar, that is, manic depression. It takes about 6 years from the first attack to the second attack, and then the interval is shortened. Monophasic depression has a long onset time, but fewer episodes and a good prognosis. Generally speaking, about 70% patients recover or improve, but the suicide rate is high, which is estimated to be 14% in the United States, and 1 person commits suicide in every 40 cases.
Treatment:
Commonly used drugs are: tricyclic antidepressants, including imipramine, amitriptyline and doxepin, with daily dosage of 150~300mg, and the dosage should be gradually increased; If the drug is ineffective for 4 weeks, consider changing the medicine. Another available new drug is lofomizine and nitrogen mustard butyrate: it is effective for about 60%~70% of patients, and it usually takes 10~ 14 days to have a good effect; The monoamine oxidase inhibitor can be 75-200mg of urea amine per day, and the other can be 45-75mg of phenelzine and 65,438+00-30mg of isoniazid per day. Lithium salt: Lithium salt is effective for mania and depression, and can be used alone or in combination with antipsychotics. The effective rate for mania can reach about 80%. The commonly used lithium salt is lithium carbonate. The appropriate therapeutic dose in acute phase is 1.0~2.5g/d, and the maintenance dose is 0.5 ~1.0g/d. Because the therapeutic dose is close to the toxic dose, there are many adverse reactions. Use with caution in patients with renal insufficiency and heart disease.
Mental disorder during lactation
Etiology:
Transient emotional depression occurred 3~ 10 days after delivery.
Symptoms:
There are four main symptoms: crying, depression, anxiety and confusion. It is a mental disorder between postpartum psychosis and maternal depression. Precursor symptoms can include emotional instability, crying, irritability, insomnia, anxiety, irritability, fear, doubt and so on. A few days later, there were all kinds of horrible performances.
Individual performance is unable to walk, stand and so on. Depression or mania, depression, pessimism, negativity, guilt and self-blame, a few people have serious evil thoughts and nihilistic delusions, and mania is rare; Mental disorders, auditory hallucinations; Schizophrenia, emotional stress, obvious auditory hallucination, thinking disorder, persecution paranoia, sudden infanticide or suicide.
The incidence reported abroad is 3.5%~33%, and that reported in Chen Yanjie is 20%. It is believed that the occurrence of postpartum depression is obviously related to occupation, family income, family relationship, delivery mode, hospitalization environment and hospital service quality.
Treatment:
Antidepressants and antipsychotics can be used, and breastfeeding should be stopped when taking the medicine; Use antibiotics to prevent infection; Giving thyroxine to people with long-term depression can sometimes achieve better results; For severe depression or coma, electroconvulsive therapy can be considered, but it is not suitable for postpartum 1 month, because there is venous thrombosis in pelvic cavity, which can fall off during electroconvulsive therapy, causing embolism of important organs such as lungs.
Because mental patients generally take a lot of drugs for a long time, doctors should fully consider the adverse reactions of various drugs. Schizophrenia often recurs in puerperium 1 month, and seems to have antipsychotic ability during pregnancy, especially in the early pregnancy. However, in the puerperium, due to the special physiological and psychological state after delivery, it is easy to relapse or aggravate, so the dosage should be increased after delivery. Zhao Guifang et al. (1994) studied the postpartum condition and treatment of mental patients, and found that the total volatility of postpartum schizophrenia was 49.40%, including 46.99% relapse, 5 1.75% aggravation, 50.00% affective disorder and 62.50% hysteria.
In order to prevent the recurrence or aggravation of the postpartum condition of mental patients, the dosage of mental patients taking maintenance treatment drugs during pregnancy should be appropriately increased after delivery, and adequate and effective antipsychotic drugs should be given to mental patients who did not maintain treatment during pregnancy as soon as possible after delivery. People who are extremely nervous, have severe depressive symptoms and are very excited can be treated with electroconvulsive therapy. At present, the drugs used to treat mental illness are mostly fat-soluble, which can pass through the blood-brain barrier and placental barrier and have certain influence on the fetus. The pharmaceutical ingredients in breast milk are also high. Therefore, it is best for mental patients not to breastfeed during taking medicine. [ 1]
4 diet therapy
1, shredded pork and bitter gourd
Practice: Take 300g of bitter gourd and 50g of lean pork/kloc-0. Shred bitter gourd, add water to boil, and discard bitter soup. Slice lean meat, stir-fry in oil, stir-fry with shredded bitter gourd, and add seasoning to serve.
Pork shredded bitter gourd is suitable for pregnant women: it has a very good therapeutic effect on patients with postpartum depression, irritability, emotional instability and irritability.
2. Lotus seed and jujube soup
Practice: Take 3 grams of lotus plumule and jujube 10. Decoct lotus plumule powder and jujube together, once a day, after meals.
This diet is suitable for pregnant women with obvious anxiety.
3. Lily catches lotus seeds
Practice: Take water to make lily 100g, lotus seeds 50g, water-made daylily and appropriate amount of rock sugar. Wash lily and day lily with clear water, peel, remove the heart and wash lotus seeds, put them into a big soup bowl, put a proper amount of clear water into the soup bowl, steam them in a cage with strong fire, and add rock sugar to steam for a while.
Lily fishing for lotus seeds is suitable for mental patients who don't think about diet, look depressed, suffer from insomnia and dreaminess, and are easy to wake up.