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},
"code": "T79.4",
"name": "Травматический шок",
"icd_name": "Травматический шок",
"gender": 0,
"age_min": 1,
"age_max": 100,
"cause": [
"0",
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],
"periodicity": 1,
"slug": "t79.4_travmaticheskiy_shok",
"lead": "патологическое состояние, которое возникает вследствие кровопотери и болевого синдрома при травме",
"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;\">Травматический шок — тяжёлое, угрожающее жизни больного, патологическое состояние, возникающее при тяжёлых травмах, таких как переломы костей таза, тяжёлые огнестрельные ранения, черепно-мозговая травма, травма живота с повреждением внутренних органов, операциях, большой потере крови.</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;\">Травматический шок развивается при всех видах тяжелых травм, вне зависимости от их причины, локализации и механизма повреждения. Его причиной могут стать ножевые и огнестрельные ранения, падения с высоты, автомобильные аварии, техногенные и природные катастрофы, несчастные случаи на производстве и т. д. Кроме обширных ран с повреждением мягких тканей и кровеносных сосудов, а также открытых и закрытых переломов крупных костей (особенно множественных и сопровождающихся повреждением артерий) травматический шок могут вызывать обширные ожоги и отморожения, которые сопровождаются значительной потерей плазмы.</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;\">В основе развития травматического шока лежит массивная кровопотеря, выраженный болевой синдром, нарушение функции жизненно важных органов и психический стресс, обусловленный острой травмой. При этом потеря крови играет ведущую роль, а влияние остальных факторов может существенно различаться. Так, при повреждении чувствительных зон (промежности и шеи) возрастает влияние болевого фактора, а при травме грудной клетки состояние больного усугубляется нарушением функции дыхания и обеспечения организма кислородом.</span></p>",
"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;\">Пусковой механизм травматического шока в значительной степени связан с централизацией кровообращения – состоянием, когда организм направляет кровь к жизненно важным органам (легким, сердцу, печени, мозгу и т.д.), отводя ее от менее важных органов и тканей (мышц, кожи, жировой клетчатки). Мозг получает сигналы о нехватке крови и реагирует на них, стимулируя надпочечники выбрасывать адреналин и норадреналин. Эти гормоны действуют на периферические сосуды, заставляя их сужаться. В результате кровь оттекает от конечностей и ее становится достаточно для работы жизненно важных органов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Спустя некоторое время механизм начинает давать сбои. Из-за отсутствия кислорода периферические сосуды расширяются, поэтому кровь оттекает от жизненно важных органов. При этом из-за нарушений тканевого обмена стенки периферических сосудов перестают реагировать на сигналы нервной системы и действие гормонов, поэтому повторного сужения сосудов не происходит, и «периферия» превращается в депо крови. Из-за недостаточного объема крови нарушается работа сердца, что еще больше усугубляет нарушения кровообращения. Падает артериальное давление. При значительном снижении АД нарушается нормальная работа почек, а чуть позже – печени и кишечной стенки. Из стенки кишок в кровь выбрасываются токсины. Ситуация усугубляется из-за возникновения многочисленных очагов омертвевших без кислорода тканей и грубого нарушения обмена веществ.</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;\">Из-за спазма и повышения свертываемости крови часть мелких сосудов закупоривается тромбами. Это становится причиной развития ДВС-синдрома (синдрома диссеминированного внутрисосудистого свертывания), при котором свертывание крови сначала замедляется, а затем практически исчезает. При ДВС-синдроме может возобновиться кровотечение в месте травмы, возникает патологическая кровоточивость, появляются множественные мелкие кровоизлияния в кожу и внутренние органы. Все перечисленное приводит к прогрессирующему ухудшению состояния больного и становится причиной летального исхода.</span></p>",
"diagnostics": "<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;\">Травматический шок диагностируют при выявлении соответствующей симптоматики, наличии свежей травмы или другой возможной причины возникновения данной патологии. Для оценки состояния пострадавшего производят периодические измерения пульса и артериального давления, назначают лабораторные исследования. Перечень диагностических процедур определяется патологическим состоянием, вызвавшим развитие травматического шока.</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;\">На этапе первой помощи необходимо провести временную остановку кровотечения (жгут, тугая повязка), восстановить проходимость дыхательных путей, выполнить обезболивание и иммобилизацию, а также предупредить переохлаждение. Перемещать больного следует очень осторожно, чтобы не допустить повторной травматизации.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">В стационаре на начальном этапе реаниматологи-анестезиологи осуществляют переливание солевых (лактасол, раствор Рингера) и коллоидных (реополиглюкин, полиглюкин, желатиноль и т. д.) растворов. После определения резуса и группы крови продолжают переливание указанных растворов в сочетании с кровью и плазмой. Обеспечивают адекватное дыхание, используя воздуховоды, оксигенотерапию, интубацию трахеи или ИВЛ. Продолжают обезболивание. Выполняют катетеризацию мочевого пузыря для точного определения количества мочи.</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;\">Оперативные вмешательства проводят по жизненным показаниям в объеме, необходимом для сохранения жизнедеятельности и предотвращения дальнейшего усугубления шока. Осуществляют остановку кровотечения и обработку ран, блокаду и иммобилизацию переломов, устранение пневмоторакса и т. д. Назначают гормонотерапию, и дегидратацию, применяют препараты для борьбы с гипоксией головного мозга, корректируют обменные нарушения.</span></p>",
"prevention": "<p><span id=\"docs-internal-guid-a21c2c70-7fff-984b-8c63-0474020fdeaf\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Своевременное выявление признаков травматического шока и вовремя принятые профилактические меры позволяют предотвратить его переход в более тяжелую стадию еще на доврачебном периоде оказания помощи пострадавшему. </span></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;\">В эректильной фазе пациент возбужден, жалуется на боль, может кричать или стонать. Он тревожен и испуган. Нередко наблюдается агрессия, сопротивление обследованию и лечению. Кожа бледная, артериальное давление немного повышено. Отмечается тахикардия, тахипноэ (учащение дыхания), дрожание конечностей или мелкие подергивания отдельных мышц. Глаза блестят, зрачки расширены, взгляд беспокойный. Кожа покрыта холодным липким потом. Пульс ритмичный, температура тела нормальная или немного повышенная. На этой стадии организм еще компенсирует возникшие нарушения. </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;\">Грубые нарушения деятельности внутренних органов отсутствуют, ДВС-синдрома нет.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">С наступлением торпидной фазы травматического шока пациент становится апатичным, вялым, сонливым и депрессивным. Несмотря на то, что боль в этот период не уменьшается, больной перестает или почти перестает о ней сигнализировать. Он больше не кричит и не жалуется, может лежать безмолвно, тихо постанывая, или вовсе потерять сознание. Реакция отсутствует даже при манипуляциях в области повреждения. Артериальное давление постепенно снижается, а частота сердечных сокращений увеличивается. Пульс на периферических артериях ослабевает, становится нитевидным, а затем перестает определяться.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Глаза больного тусклые, запавшие, зрачки расширенные, взгляд неподвижный, под глазами тени. Отмечается выраженная бледность кожных покровов, цианотичность слизистых, губ, носа и кончиков пальцев. Кожа сухая и холодная, упругость тканей снижена. Черты лица заострены, носогубные складки сглажены. Температура тела нормальная или пониженная (возможно также повышение температуры из-за раневой инфекции). Пациента бьет озноб даже в теплом помещении. Нередко наблюдаются судороги, непроизвольное выделение кала и мочи.</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;\">Выявляются симптомы интоксикации. Больной мучается от жажды, язык обложен, губы запекшиеся, сухие. Может наблюдаться тошнота, а в тяжелых случаях даже рвота. Из-за прогрессирующего нарушения работы почек количество мочи уменьшается даже при обильном питье. Моча темная, концентрированная, при тяжелом шоке возможна анурия (полное отсутствие мочи).</span></p>",
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},
"code": "F21",
"name": "Шизотипическое расстройство",
"icd_name": "Шизотипическое расстройство",
"gender": 0,
"age_min": 0,
"age_max": 94,
"cause": [
3
],
"periodicity": 1,
"slug": "f21_shizotipicheskoe_rasstroystvo",
"lead": "Нарушение здоровья, относящееся к группе шизофрения, шизотипические состояния и бредовые расстройства",
"description": "Шизотипическим считается расстройство, в симптоматике которого проявляются мыслительная, поведенческая, эмоциональная и социальная аномалии, характерные для шизофрении, но отличные от нее своим менее выраженным характером. ",
"etiology": "<p>К предполагаемым причинам причинам шизотипического расстройства относятся: </p>\r\n<ul>\r\n<li>Наследственная предрасположенность, провоцирующая повышенную активность дофамина; </li>\r\n<li>Нехватка внимания в детском возрасте; </li>\r\n<li>Частые стрессовые ситуации; </li>\r\n<li>Патология беременности. </li>\r\n</ul>",
"pathogenesis": "<p>У таких больных нарушается обмен веществ в головном мозге, что является причиной нарушений. Между клетками мозга теряется старая «правильная» цепочка передачи информации, и сообщения между нейронами происходит совершенно в хаотичном порядке. Это и вызывает всю последующую симптоматику. Запустить болезнь в действие может плохое и негативное социальное окружение, резкие изменения в жизни человека, стрессы, замкнутость от социума на длительное время или же тяжелые вирусные инфекции, которыми переболел человек. <br class=\"SCXW224023875\" /> </p>",
"diagnostics": "<p>Критерии постановки диагноза шизотипического расстройства по МКБ-10: </p>\r\n<ul>\r\n<li>Эмоциональная холодность, отрешенность. </li>\r\n<li>Эксцентричность, странность поведения. </li>\r\n<li>Плохой контакт с другими людьми. </li>\r\n<li>Странные убеждения или магическое мышление, влияющие на поведение и несовместимые с субкультуральными нормами. </li>\r\n<li>Подозрительность или параноидные идеи. </li>\r\n<li>Навязчивые размышления, часто с сексуальным или агрессивным содержанием. </li>\r\n<li>Необычные феномены восприятия, включая соматосенсорные (телесные) или другие иллюзии, деперсонализация или дереализация. </li>\r\n<li>Обстоятельное, детализированное или стереотипное мышление, проявляющееся странной, вычурной речью. </li>\r\n<li>Эпизоды с иллюзиями, слуховыми или другими галлюцинациями, бредоподобными идеями. </li>\r\n</ul>\r\n<p>На протяжении минимум двух лет должны обнаруживаться хотя бы 4 признака из вышеперечисленных. </p>",
"treatment": "<p>Для лечения шизотипического расстройства назначают следующие лекарственные препараты: </p>\r\n<p>Успокоительные средства </p>\r\n<p>Нейролептики назначаются, чтобы подавить психотические симптомы, такие как бред, галлюцинации и паранойя. К нейролептикам относятся такие препараты как клозапин, рисперидон и оланзапин. </p>\r\n<p>Стабилизаторы настроения </p>\r\n<p>Стабилизаторы настроения назначаются при шизоаффективном расстройстве биполярного типа. Они помогают держать под контролем аффективную сторону заболевания, смягчая периоды мании и депрессии, характерные для биполярного расстройства. Наиболее распространёными стабилизаторами настроения являются препараты лития. </p>\r\n<p>Антидепрессанты </p>\r\n<p>При шизоаффективном расстройстве депрессивного типа назначаются антидепрессанты. Они помогают побороть чувство безнадёжности, печали, нормализуют сон и улучшают концентрацию внимания. Наиболее часто назначаются циталопрам, флуоксетин и эсциталопрам. </p>\r\n<p>Из немедикаментозной терапии часто применяются следующие методы </p>\r\n<p>Психотерапия </p>\r\n<p>Выстраивание доверительных отношений с врачом в ходе психотерапии помогает пациенту лучше понять свою болезнь и с большей уверенностью смотреть в будущее. Сеансы психотерапии учат пациента ставить реальные жизненные цели, решать проблемы и выстраивать взаимоотношения. Пациент может быть обучен новым поведенческим стратегиям, которые будут способствовать более эффективному общению дома и на работе. </p>\r\n<p>Семейная или групповая терапия </p>\r\n<p>Лечение может быть более эффективным, если люди, страдающие шизоаффективным расстройством, будут иметь возможность обсудить свою жизнь и проблемы с людьми, страдающими таким же заболеванием. Появление группы поддержки также может уменьшить социальную изоляцию больных и обеспечить постоянный контроль за ними. </p>",
"prevention": "<p>Специфических методов профилактики нет, так как это заболевание не имеет чёткой этиологии. Снизить риск его развития можно, если вести правильный образ жизни не только в физиологическом, но и психологическом понимании. При первых же проявлениях вышеописанной клинической картины следует обращаться за консультацией к психиатру. </p>",
"clinical_picture": "<p>Пациенты с имеющиеическим расстройством личности отличаются бессвязной манерой разговоров, не имеющей логического начала и конца. Для них характерно общаться обрывками фраз, перескакивать с одной темы на другую или же повторять одно и тоже по несколько раз. Слыша такую речь, окружающие с трудом ее воспринимают или не понимают вовсе, что такой больной хочет сказать. </p>\r\n<p>Коммуникативные навыки с внешним миром возможны только с теми людьми, которые знают о заболевании и смогли адаптироваться к странному поведению. Незнакомые и чужие могут вызвать у больных агрессию, гнев, приступ паники, раздражительность. </p>\r\n<p>При шизотипическом расстройстве личности наблюдается общение с невидимыми людьми. Чаще всего пациенты разговаривают сами с собой или с воображаемыми персонажами. Последние могут быть как реальными, так и выдуманными. Такие периоды общения характеризуются открытостью со стороны больного. Он может плакать, кричать, пытаться что-то доказать несуществующему рядом человеку; может делиться всеми своими переживаниями и страхами, которые связаны с чем-то, что человек пережил далеко в прошлом, в юности или детстве. Это может быть все, что угодно: изнасилование, издевательства, насмешки со стороны взрослых и детей и т. д. </p>\r\n<p>Для людей с шизотипическим расстройством характерно отчуждение от социума и постоянное, нескрываемое желание быть одним. Сам же человек с таким заболеванием не считает себя одиноким. </p>\r\n<p>Постоянное изменение в настроении также является одним из симптомов заболевания. Вспышки гнева безо всяких на то причин, ярость, плач, бросание рядом стоящих предметов обихода — все это характерно для людей с шизотипическим расстройством. </p>\r\n<p>Навязчивость идей вплоть до параноидального синдрома на фоне постоянного беспокойства и подозрительности ко всему происходящему вокруг. </p>\r\n<p> </p>",
"image": null,
"image_alt": null,
"standard_type": 3,
"danger": 1,
"published": 2,
"parent": null,
"block_rubric": 55,
"standards": [
5120
]
},
{
"id": 6308,
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{
"id": 2852,
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{
"name": "нарушение речи"
},
{
"name": "бедность речи"
},
{
"name": "неясная речь"
}
],
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"code": "F21",
"name": "Шизотипическое расстройство",
"icd_name": "Шизотипическое расстройство",
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"slug": "f21_shizotipicheskoe_rasstroystvo",
"lead": "Нарушение здоровья, относящееся к группе шизофрения, шизотипические состояния и бредовые расстройства",
"description": "Шизотипическим считается расстройство, в симптоматике которого проявляются мыслительная, поведенческая, эмоциональная и социальная аномалии, характерные для шизофрении, но отличные от нее своим менее выраженным характером. ",
"etiology": "<p>К предполагаемым причинам причинам шизотипического расстройства относятся: </p>\r\n<ul>\r\n<li>Наследственная предрасположенность, провоцирующая повышенную активность дофамина; </li>\r\n<li>Нехватка внимания в детском возрасте; </li>\r\n<li>Частые стрессовые ситуации; </li>\r\n<li>Патология беременности. </li>\r\n</ul>",
"pathogenesis": "<p>У таких больных нарушается обмен веществ в головном мозге, что является причиной нарушений. Между клетками мозга теряется старая «правильная» цепочка передачи информации, и сообщения между нейронами происходит совершенно в хаотичном порядке. Это и вызывает всю последующую симптоматику. Запустить болезнь в действие может плохое и негативное социальное окружение, резкие изменения в жизни человека, стрессы, замкнутость от социума на длительное время или же тяжелые вирусные инфекции, которыми переболел человек. <br class=\"SCXW224023875\" /> </p>",
"diagnostics": "<p>Критерии постановки диагноза шизотипического расстройства по МКБ-10: </p>\r\n<ul>\r\n<li>Эмоциональная холодность, отрешенность. </li>\r\n<li>Эксцентричность, странность поведения. </li>\r\n<li>Плохой контакт с другими людьми. </li>\r\n<li>Странные убеждения или магическое мышление, влияющие на поведение и несовместимые с субкультуральными нормами. </li>\r\n<li>Подозрительность или параноидные идеи. </li>\r\n<li>Навязчивые размышления, часто с сексуальным или агрессивным содержанием. </li>\r\n<li>Необычные феномены восприятия, включая соматосенсорные (телесные) или другие иллюзии, деперсонализация или дереализация. </li>\r\n<li>Обстоятельное, детализированное или стереотипное мышление, проявляющееся странной, вычурной речью. </li>\r\n<li>Эпизоды с иллюзиями, слуховыми или другими галлюцинациями, бредоподобными идеями. </li>\r\n</ul>\r\n<p>На протяжении минимум двух лет должны обнаруживаться хотя бы 4 признака из вышеперечисленных. </p>",
"treatment": "<p>Для лечения шизотипического расстройства назначают следующие лекарственные препараты: </p>\r\n<p>Успокоительные средства </p>\r\n<p>Нейролептики назначаются, чтобы подавить психотические симптомы, такие как бред, галлюцинации и паранойя. К нейролептикам относятся такие препараты как клозапин, рисперидон и оланзапин. </p>\r\n<p>Стабилизаторы настроения </p>\r\n<p>Стабилизаторы настроения назначаются при шизоаффективном расстройстве биполярного типа. Они помогают держать под контролем аффективную сторону заболевания, смягчая периоды мании и депрессии, характерные для биполярного расстройства. Наиболее распространёными стабилизаторами настроения являются препараты лития. </p>\r\n<p>Антидепрессанты </p>\r\n<p>При шизоаффективном расстройстве депрессивного типа назначаются антидепрессанты. Они помогают побороть чувство безнадёжности, печали, нормализуют сон и улучшают концентрацию внимания. Наиболее часто назначаются циталопрам, флуоксетин и эсциталопрам. </p>\r\n<p>Из немедикаментозной терапии часто применяются следующие методы </p>\r\n<p>Психотерапия </p>\r\n<p>Выстраивание доверительных отношений с врачом в ходе психотерапии помогает пациенту лучше понять свою болезнь и с большей уверенностью смотреть в будущее. Сеансы психотерапии учат пациента ставить реальные жизненные цели, решать проблемы и выстраивать взаимоотношения. Пациент может быть обучен новым поведенческим стратегиям, которые будут способствовать более эффективному общению дома и на работе. </p>\r\n<p>Семейная или групповая терапия </p>\r\n<p>Лечение может быть более эффективным, если люди, страдающие шизоаффективным расстройством, будут иметь возможность обсудить свою жизнь и проблемы с людьми, страдающими таким же заболеванием. Появление группы поддержки также может уменьшить социальную изоляцию больных и обеспечить постоянный контроль за ними. </p>",
"prevention": "<p>Специфических методов профилактики нет, так как это заболевание не имеет чёткой этиологии. Снизить риск его развития можно, если вести правильный образ жизни не только в физиологическом, но и психологическом понимании. При первых же проявлениях вышеописанной клинической картины следует обращаться за консультацией к психиатру. </p>",
"clinical_picture": "<p>Пациенты с имеющиеическим расстройством личности отличаются бессвязной манерой разговоров, не имеющей логического начала и конца. Для них характерно общаться обрывками фраз, перескакивать с одной темы на другую или же повторять одно и тоже по несколько раз. Слыша такую речь, окружающие с трудом ее воспринимают или не понимают вовсе, что такой больной хочет сказать. </p>\r\n<p>Коммуникативные навыки с внешним миром возможны только с теми людьми, которые знают о заболевании и смогли адаптироваться к странному поведению. Незнакомые и чужие могут вызвать у больных агрессию, гнев, приступ паники, раздражительность. </p>\r\n<p>При шизотипическом расстройстве личности наблюдается общение с невидимыми людьми. Чаще всего пациенты разговаривают сами с собой или с воображаемыми персонажами. Последние могут быть как реальными, так и выдуманными. Такие периоды общения характеризуются открытостью со стороны больного. Он может плакать, кричать, пытаться что-то доказать несуществующему рядом человеку; может делиться всеми своими переживаниями и страхами, которые связаны с чем-то, что человек пережил далеко в прошлом, в юности или детстве. Это может быть все, что угодно: изнасилование, издевательства, насмешки со стороны взрослых и детей и т. д. </p>\r\n<p>Для людей с шизотипическим расстройством характерно отчуждение от социума и постоянное, нескрываемое желание быть одним. Сам же человек с таким заболеванием не считает себя одиноким. </p>\r\n<p>Постоянное изменение в настроении также является одним из симптомов заболевания. Вспышки гнева безо всяких на то причин, ярость, плач, бросание рядом стоящих предметов обихода — все это характерно для людей с шизотипическим расстройством. </p>\r\n<p>Навязчивость идей вплоть до параноидального синдрома на фоне постоянного беспокойства и подозрительности ко всему происходящему вокруг. </p>\r\n<p> </p>",
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