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The State Education Institution of Higher Professional Training
The First Sechenov Moscow State Medical University
under Ministry of Health of the Russian Federation
Department of Pathophysiology
Neurosis
Lecture presentation
Professor Pirozhkov S.V.
2015-2016 education year
MODELING OF NEUROSIS WITH
PREDOMINANCE OF INHIBITION
● Use of conditioned stimulus of extreme
intensity
● Exposure to simultaneous effects of
several strong stimuli
● Exposure to the effect of complex
conditioned or unusual stimuli
MODELING OF NEUROSIS WITH
PREDOMINANCE OF EXCITATION
● Undue delays in providing food
reinforcement
● Complex discrimination tasks
● The need to develop several different
discriminations in one experimental
session
MODELING OF NEUROSIS WITH A
PATHOLOGICAL LABILITY OF THE MAIN
NERVOUS PROCESSES (EXCITATION AND
INHIBITION)
● Sudden change in the meaning of the
conditioned stimulus
● Abrupt change of the habitual
environment
● Collision of different reflexes (for
example, alimentary and defensive)
Neurosis –
● typical form of disorder of the higher nervous
functions
● that is potentially reversible
● caused by psychological stress and
● characterized by disorders of mood, emotions,
behavior, mentation, and general decrease of
well-being without degradation of a personality
or loss of judgment
● often accompanied by autonomous symptoms
and, in some types, by disorders of sensation
and locomotion
FACTORS THAT FOSTER INADEQUATE ADAPTATION
IN NEUROTIC CONFLICT
● Faulty upbringing
● Negative experiences in early
childhood or formative years of life
● Personal traits
● Hereditary predisposition
● Unfavourable circumstances, hard
conditions of life
THE CORRESPODENCE OF CLASSICAL NEUROSES TO MODERN
NOSOLOGICAL FORMS ACCORDING TO ICD-10
F40. Phobic disorders
(agoraphobia, social phobia etc.)
Compulsion
neurosis
F42. Obsessive-compulsive
disorders
F44. Dissociative (conversion)
disorders
Hysteric
neurosis
F45. Somatoform disorders
F48.0. Neurasthenia
Neurasthenia
DISSOCIATIVE (CONVERSION) DISORDERS
Characteristic features:
- sudden, temporary alteration in the integrative
functions of consciousness
- loss of memory or identity
- deficit of voluntary motor and sensory function
- these deficits are temporary, and not intentionally
produced or simulated
SOMATOFORM DISORDERS
HYPOCHONDRIASIS
A belief of serious illness that
persists despite reassurance
and appropriate medical
evaluation
SOMATIZATION
DISORDER
Preoccupation of a patient
with somatic complaints with
a focus more on specific
symptoms rather than on fear
of specific disease
Common phobias:
● Fear of closed spaces (claustrophobia)
● Fear of blood
● Fear of flying
● Social phobia
● Agoraphobia
Pathophysiology of obsessive-compulsive disorders
Brain cortex
Motor cortex
Nucleus caudatum
volume decrease
Orbitofrontal
cortex
Alteration
Basal ganglia
Nucleus
caudatum
Putamen
Globus
pallidus
Substantia
nigra
Brain stem
Thalamus
Neurasthenia
● emphasis on fatigability and
weakness
● concern about lowered mental and
physical efficiency
● unpleasant feelings of dizziness,
tension, headaches, general
instability, irritability, anhedonia
I type:
● complaint of increased
fatigability after mental effort
● decrease in occupational
performance or coping
efficiency in daily tasks
II type:
● emphasis on physical
weakness and exhaustion
after only minimal effort
● feeling of muscular aches
and pain and inability to relax