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"icd_name": "Психические и поведенческие расстройства, вызванные одновременным употреблением нескольких психоактивных веществ",
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"lead": "Нарушение здоровья, относящееся к группе психические расстройства и расстройства поведения, связанные с употреблением психоактивных веществ",
"description": "Полинаркомания – заболевание, связанное с употреблением двух и более наркотических средств одновременно или в определенной последовательности, при чем ко всем им сформирована зависимость. Сочетанное употребление различных психоактивных веществ изменяет клинику заболевания, влияет на темп формирования основных симптомов и синдромов, приводит к более тяжелым медицинским и социальным последствиям.",
"etiology": "<p>Факторами риска развития полинаркомании являются условия, способствующие повторному применению психоактивных веществ:</p>\r\n<ul>\r\n<li>Социальные – низкий материальный уровень, информационные перегрузки, стрессы, национальные обычаи, окружающая социальная среда, случаи злоупотребления психоактивными веществами в семейном анамнезе и т.д.;</li>\r\n<li>Психологические – низкая социальная адаптированность, психические расстройства (особенно депрессия);</li>\r\n<li>Биологические – наследственная предрасположенность к применению психоактивных веществ, молодой возраст, сопутствующие соматические и неврологические заболевания.</li>\r\n</ul>",
"pathogenesis": "<p>Прием психоактивного вещества вызывает индивидуальные, более или менее выраженные положительные эмоции. Это побуждает к повторному использованию этого вещества (феномен «подкрепления»). Каждый эпизод искусственно вызванного состояния комфорта способствует формированию патологической системы достижения этого состояния. Функция этой системы имеет целью прием очередной (подкрепляющей) порции вещества для достижения психологического и физического комфорта.</p>\r\n<p>Медиаторами патологической системы подкрепления являются дофамин, норадреналин, серотонин, эндогенные опиоиды. Наркотики и другие психоактивные вещества активируют систему подкрепления. Это сопровождается выбросом дополнительных количеств нейромедиаторов из мест их депонирования. Они обеспечивают развитие очередного эпизода эйфории, хорошего настроения, повышения работоспособности. Так формируется устойчивое патологическое влечение к повторному приему психоактивного вещества. Затем, со временем, запасы нейромедиаторов постепенно истощаются в связи с повторным приемом психоактивных веществ, снижается активность системы подкрепления, развивается тягостное чувство психоэмоционального дискомфорта, озлобленности, упадка физических и умственных сил, формируется непреодолимая потребность повторного стимулирования организма приемом психоактивных средств – психической зависимости. Повышается толерантность к психоактивному веществу, в результате для поддержания комфортного состояния пациенту требуется постоянное увеличение дозы вещества. Также происходит адаптация к негативным эффектам психоактивных веществ – нивелируются тошнота, рвота, головная боль и т.д., возникавшие ранее при приеме наркотиков, алкоголя и других веществ.</p>\r\n<p>Развитие стадии физической зависимости связано с накоплением избытка дофамина в ткани мозга в связи с прекращением или существенным снижением содержания психоактивных веществ в организме. Это является ключевым фактором в развитии абстинентного синдрома. В то же время прогрессирует повышение толерантности к психоактивному веществу, больные увеличивают дозу вплоть до токсической.</p>\r\n<p>Финальная стадия наркомании представляет собой комплекс патогенных синдромов:</p>\r\n<ul>\r\n<li>Синдром физической зависимости организма от психоактивного вещества. Представляет собой следствие включения этого вещества и/или его метаболитов в качестве компонентов и регуляторов обмена веществ в нервной ткани и органах;</li>\r\n<li>Синдром сниженной толерантности к психоактивному веществу. Он проявляется тем, что потребление этого вещества становится более редким, но обязательным; доза вещества уменьшается, потребление его уже не сопровождается устранением дискомфорта и развитием эйфории. Оно позволяет лишь избежать абстинентного синдрома или уменьшить тяжесть его течения;</li>\r\n<li>Синдром полиорганной недостаточности;</li>\r\n<li>Синдром деградации личности.</li>\r\n</ul>\r\n<p> </p>\r\n<p> </p>",
"diagnostics": "<p>Постановка диагноза полинаркомании представляет собой непростую задачу, что связано с усложняющейся клинической картиной заболевания, обусловленной сочетанным действием нескольких психоактивных веществ на организм.</p>\r\n<p>Обследование больных полинаркоманией включает в себя осмотр нарколога и психиатра.</p>\r\n<p>По показаниям назначают дополнительные исследования (ЭКГ, ЭхоЭГ, УЗИ внутренних органов и т. д.), консультации терапевта, кардиолога, невролога, гастроэнтеролога и других специалистов.</p>\r\n<p>Для подтверждения приема наркотических или токсических средств при полинаркомании выполняют экспертизу алкогольного опьянения и тест на наркотики. Для оценки регулярности употребления применяют анализ волос на наркотики и определение антител к наркотическим веществам. Важным аргументом в пользу полинаркомании являются особенности абстинентного синдрома, представляющие собой сочетание признаков зависимости от нескольких психоактивных веществ.</p>\r\n<p>Проводятся также:</p>\r\n<ul>\r\n<li>Токсикологическое исследование (в течение 2 дней после употребления большинства препаратов) мочи и крови</li>\r\n<li>Скрининг-тесты психоактивного вещества — неспецифичные, высока вероятность ошибки</li>\r\n<li>Психологическое тестирование. </li>\r\n</ul>",
"treatment": "<p>Лечение полинаркомании осуществляется в стационаре, так как множественная зависимость часто сопровождается грубыми личностными и волевыми нарушениями, отсутствием критики к своему состоянию и повышенной агрессивностью. В ряде случаев больные с полинаркоманией могут представлять опасность для окружающих.</p>\r\n<p>Пациенту, страдающему полинаркоманией, проводят дезинтоксикационную терапию, назначают препараты для восстановления обмена веществ, нормализации психического состояния и улучшения функций различных органов и систем. </p>\r\n<p>Медикаментозное лечение полинаркомании осуществляют на фоне психологической поддержки. С больными полинаркоманией работает психотерапевт, возможны как индивидуальные консультации, так и занятия в группе. Оптимальным вариантом при полинаркомании является длительная реабилитация в специализированном центре с последующим регулярным амбулаторным наблюдением.</p>",
"prevention": "<p>Профилактика включает в себя:</p>\r\n<ul>\r\n<li>Полное воздержание от приёма психоактивного вещества;</li>\r\n<li>Пропаганду здорового образа жизни;</li>\r\n<li>Лечение сопутствующих соматических и психических расстройств с последующей поддерживающей терапией;</li>\r\n<li>Психотерапия. </li>\r\n</ul>",
"clinical_picture": "<p>Наиболее распространены комбинации следующих психоактивных веществ:</p>\r\n<ul>\r\n<li>Алкоголя с седативными средствами, реже с марихуаной и кокаином;</li>\r\n<li>Опиоидов с марихуаной, кокаином, амфетаминами, с алкоголем.</li>\r\n</ul>\r\n<p>Для постановки диагноза зависимости необходимо наличие следующих признаков:</p>\r\n<ul>\r\n<li>Синдром изменённой реактивности организма на действие данного психоактивного вещества (исчезновение защитных реакций, изменение толерантности, формы потребления и формы опьянения);</li>\r\n<li>Синдром психической зависимости (обсессивное (навязчивое) влечение, ощущение психического комфорта при наркотическом опьянении);</li>\r\n<li>Синдром физической зависимости (компульсивное влечение, потеря контроля над дозой, абстинентный синдром, физический комфорт при наркотическом опьянении);</li>\r\n<li>Синдром отмены (абстиненция, абстинентный синдром) — специфический синдром, возникающий в результате прекращения интенсивного употребления психоактивных веществ (характерны толерантность и признаки зависимости). Вещества с более короткой продолжительностью действия вызывают более непродолжительную и более интенсивную абстиненцию, а вещества с более длительным действием вызывают пролонгированную, но менее тяжёлую абстиненцию. </li>\r\n</ul>\r\n<p>В основном заболевание клинически проявляется:</p>\r\n<ul>\r\n<li>обширным поражением внутренних органов и ЦНС;</li>\r\n<li>сильным изменением личности;</li>\r\n<li>агрессивностью и асоциальностью;</li>\r\n<li>психическими расстройствами хронического и затяжного характера;</li>\r\n<li>слабоумием;</li>\r\n<li>снижением интеллектуальных способностей.</li>\r\n</ul>\r\n<p>Также может проявляться индивидуальная симптоматика. Например, галлюцинации, бессонница, головные боли и другие.</p>\r\n<p> </p>",
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"lead": "психическая болезнь, проявляющаяся искажением мышления и восприятия",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Шизофрения — это психическое расстройство, при котором происходит распад процессов мышления и эмоциональных реакций. Заболевание не вызывает нарушений сознания и не изменяет многие интеллектуальные процессы, однако при длительном его протекании, нарушается восприятие, память и внимание.</span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины возникновения точно не установлены. Большинство психиатров считают, что шизофрения является мультифакторным заболеванием, возникающим под влиянием ряда эндогенных и экзогенных воздействий. На риск развития шизофрении могут влиять:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Наследственная предрасположенность. При наличии близких родственников, страдающих этим заболеванием, риск развития шизофрении увеличивается до 10%, то есть, примерно в 20 раз по сравнению со средним риском по популяции. Вместе с тем, 60% больных имеют неотягощенный семейный анамнез.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Перинатальные вредности. К числу факторов, повышающих риск развития шизофрении, относят внутриутробные инфекции, осложненные роды и время рождения.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Социальные условия. Отмечают устойчивую корреляцию распространенности шизофрении с рядом социальных факторов, в том числе – уровнем урбанизации (горожане болеют чаще сельских жителей), бедностью, неблагоприятными условиями жизни в детском возрасте и переездами семьи в связи с неблагоприятными социальными условиями.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Стиль воспитания. Многие исследователи указывают на наличие ранних травмирующих переживаний, игнорирования жизненно важных потребностей, перенесенного в детстве сексуального или физического насилия. Большинство специалистов полагают, что риск возникновения шизофрении не зависит от стиля воспитания, при этом некоторые психиатры указывают на возможную связь болезни с грубыми нарушениями семейных отношений: пренебрежением, отвержением и отсутствием поддержки.</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Вредные зависимости. Шизофрения, алкоголизм, наркомания и токсикомания нередко тесно связаны между собой, однако отследить характер этих связей не всегда возможно. Существуют исследования, указывающие на связь обострений шизофрении с приемом стимуляторов, галлюциногенов и некоторых других психоактивных веществ. </span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Аномалии структуры головного мозга. У больных шизофренией выявляются отличия в анатомической структуре гиппокампа и височных долей, увеличение желудочков и снижение активности лобной доли, отвечающей за рассуждение, планирование и принятие решений. При этом исследователи отмечают, что перечисленные нарушения могут возникнуть вторично, под влиянием фармакотерапии, поскольку большинство пациентов, принимавших участие в исследованиях структуры головного мозга, ранее получали антипсихотические препараты.</span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Патогенез шизофрении складывается из двух отчасти взаимосвязанных видов нарушений:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нейрохимические нарушения. Дисбаланс нейротрансмиттеров (веществ, обеспечивающих передачу нервных импульсов в синапсах).</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Структурные изменения головного мозга. </span></li>\r\n</ul>\r\n<p> </p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагноз устанавливается на основании анамнеза, опроса больного, его друзей и родственников. Для постановки диагноза шизофрения необходимо наличие одного или более критериев первого ранга и двух или более критериев второго ранга, определенных МКБ-10.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">1. К критериям первого ранга относят:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">слуховые галлюцинации;</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">звучание мыслей;</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">вычурные бредовые идеи;</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">бредовые восприятия.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">2. В список критериев шизофрении второго ранга включают:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">кататонию,</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">прерывание мыслей,</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">постоянные галлюцинации (кроме слуховых),</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">нарушения поведения,</span></li>\r\n<li><span style=\"font-size: 7pt; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">негативные симптомы.</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптомы первого и второго ранга должны наблюдаться в течение месяца или более. Для оценки эмоционального состояния, психологического статуса и других параметров применяют различные тесты и шкалы, в том числе – тест Люшера, тест Лири, шкалу Карпентера, тест MMMI и шкалу PANSS.</span></p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Лечение шизофрении включает в себя медикаментозную терапию, психотерапию и мероприятия по социальной реабилитации. Основой фармакотерапии являются препараты с антипсихотическим действием. В настоящее время предпочтение чаще отдают атипичным нейролептикам, которые реже вызывают позднюю дискинезию и, по мнению специалистов, могут уменьшать негативные симптомы шизофрении. Для уменьшения выраженности побочных эффектов нейролептики комбинируют с другими лекарственными препаратами, обычно – нормотимиками и бензодиазепинами. При неэффективности других методов назначают ЭСТ и инсулинокоматозную терапию.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">После редукции или исчезновения позитивной симптоматики больного шизофренией направляют на психотерапию. Для тренировки познавательных навыков, улучшения социального функционирования, помощи при осознании особенностей собственного состояния и приспособления к этому состоянию применяют когнитивно-поведенческую терапию. Для создания благоприятной семейной атмосферы используют семейную терапию. Проводят обучающие занятия для родственников больных шизофренией, оказывают психологическую поддержку близким пациентов.</span></p>",
"prevention": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Главные методы профилактики заключаются в своевременной диагностике психического заболевания. Чем раньше обратить внимание, тем лучших результатов можно добиться при лечении первого приступа. Не смотря на то, что шизофрения относится к неизлечимым заболеваниям, если терапия будет проведена правильно, то можно добиться стойкой и позитивной ремиссии, поэтому незамедлительно стоит обращаться к врачу при первых симптомах болезни.</span></p>",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Шизофрения развивается долго и незаметно для больного. Первые признаки появляются, когда человек уверен, что он вполне здоров.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Ранние симптомы шизофрении:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 6pt; font-family: Verdana; color: #4c4c4c; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Изоляция от общества, нелюдимость.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6pt; font-family: Verdana; color: #4c4c4c; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Равнодушие к себе, друзьям и родным.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6pt; font-family: Verdana; color: #4c4c4c; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Эмоциональная холодность.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6pt; font-family: Verdana; color: #4c4c4c; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Постепенная потеря интереса ко всему, что волновало ранее.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6pt; font-family: Verdana; color: #4c4c4c; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Нарушения сна.</span></p>\r\n</li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Когда болезнь прогрессирует, возникают общие симптомы и признаки шизофрении:</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"background-color: transparent; font-family: Verdana; font-variant-numeric: normal; font-variant-east-asian: normal; font-size: 7pt; vertical-align: baseline; white-space: pre-wrap;\">Психотические (позитивные):</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-variant-numeric: normal; font-variant-east-asian: normal; font-size: 7pt; vertical-align: baseline; white-space: pre-wrap;\">Галлюцинации — больной видит и слышит то, чего нет.</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Бред — нелогичные убеждения, в которых больного невозможно переубедить.</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Беспорядочное мышление — больной то говорит слишком быстро, то останавливается в середине мысли и при этом называет несуществующие слова.</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Неестественность движений — больной шизофренией движется заторможено и замирает в неестественной позе или наоборот движется слишком быстро и дергано.</span></li>\r\n</ul>\r\n<p><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Негативные:</span></p>\r\n<ul style=\"margin-top: 0px; margin-bottom: 0px; padding-inline-start: 48px;\">\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Невозможность выражения эмоций — больной постоянно выглядит подавленным и оторванным от реальности.</span></li>\r\n<li><span style=\"font-size: 7pt; color: #000000; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Нарушение мыслительного процесса — больной плохо усваивает информацию, не может сосредоточиться и все забывает.</span></li>\r\n</ul>",
"image": null,
"image_alt": null,
"standard_type": 0,
"danger": 30,
"published": 1,
"parent": null,
"block_rubric": 55,
"standards": [
4699
]
},
{
"id": 10006,
"symptoms": [],
"alternative_names": [],
"complications": [],
"medicine_branches": [],
"who": [
{
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