Anosognosia is the absence of a critical assessment of the patient's own defect or disease

There is an opinion that awareness and acceptance of the problem is 50% of its solution. However, medicine has shown that such a seemingly simple step can not be done by every person. So, at the beginning of the last century psychiatry appeared such a term as "anosognosia." This is a special condition of the patient when he denies having a mental disorder or physical defect and even in every possible way tries to prevent therapy. Why is this happening, and is treatment possible?

Medical justification

In 1914, the Polish neurologist Joseph Babinsky first described the phenomenon of anosognosia. And initially it was understood as a violation of perception of the left half of the body, its physical defects (paralysis or paresis of limbs), as well as ignoring the surrounding reality. From a medical point of view, this process is caused by extensive destructive lesions in the brain, namely in the right parietal lobe. In another way such a state is called "Babinsky's syndrome".

Classification

Today anosognosia is a broader concept, characterized by a lack of critical evaluation of the patient's illness, dependence, defect. Simply put, the patient does not realize the presence of a pathological process in the body. This mainly concerns motor and speech disorders, loss of sight and hearing. From this position anosognosia is classified into several types:

• An anosognosia of hemiplegia (the phenomenon when a sick person after a stroke asserts that the movements in the left extremities are preserved, and if desired he can move freely).
• Anosognosia of blindness / deafness (visual and auditory images appear in the patient's mind, which he perceives as real).
• Anosognosia of aphasia (the patient's speech is defined as a "verbal crumb", but he himself does not notice errors and speech defects).
• Anosognosia of pain (partial or complete loss of response to irritating external influences).

Specialists consider such a patient's condition not as an independent ailment, but as a symptom of more complex and difficult processes in the body. On the one hand, anosognosia is one of the manifestations of some kind of mental disorder (manic syndrome, dementia, Korsakov's psychosis). On the other hand, it can be considered as a warehouse of the patient's personality (for example, with alcoholism, anorexia). There is also a third angle: a sick person, for example, under the guilt, subconsciously applies the mechanism of psychological protection. It is appropriate to talk about psychosomatic disorder.

Alcoholic anosognosia

Currently, the most common psychological condition is alcohol anosognosia. This is a negative patient's dependence on alcohol or an underestimation of the severity of the habit (hypnosognosia). At the same time, as an objective assessment, the patient should be accurately diagnosed with alcoholism.

With anosognosia of this type, the patient's behavior and self-criticism can develop in two ways. He can argue that everything goes well in his life and alcohol does not interfere with him in any way. Moreover, according to the patient, if desired, he can not at all consume alcohol. However, practice shows the opposite situation.

Another model of the patient's behavior is the partial recognition of problems with alcohol, but still their severity, in his opinion, is not so great as to resort to treatment. Listening to others, he can even try to go for light liquor, because at the unconscious level of the patient remains the belief that at any time you can simply and irrevocably stop drinking.

Each model equally suggests dissimulation - hiding the symptoms of a developing disease. A sick person intentionally reduces the amount, frequency of alcohol consumption and the degree of intoxication when communicating with family and doctors.

Korsakov's psychosis

According to some psychiatrists, anosognosia is a complex phenomenon, sometimes generalizing the symptoms of severe pathological processes. So, as a result of prolonged alcohol dependence, malnutrition and lack of nicotinic acid and vitamin B1, the patient has destructive changes in the peripheral nervous system. The consequence of this is Korsakov's psychosis. This ailment was discovered in the nineteenth century by the Russian psychiatrist Sergei Sergeevich Korsakov.

The disease is characterized by the patient's inability to navigate in space and time, loss of memory, physical defects (paresis of limbs), and false memories (shift in time and place of reality or completely fictitious situations). Such mental disorders with a lack of critical assessment of the patient's environment and their condition and refer to a type of anosognosia.

Psychosomatic disorders

A more detailed study is currently undergoing anosognosia and psychosomatic disorders, their cause-effect relationships. The influence of the somatic system of a person (that is, his mental disorders) on physiology has long been established. So, some serious ailments (alcoholism, rheumatoid arthritis, stomach ulcer) do not succumb to traditional medical treatment only because they are literally the fruit of a person's imagination. That is, certain processes occurring in the subconscious (the emergence of feelings of guilt, unforgiveness, envy, constant hatred) find an outlet on the physical level. At the same time, the patient is convinced that there are no problems in his head in the psychological sense, and the disease is not a consequence of his emotional burden. Such a state has been determined by somatic anosognosia.

Is treatment possible?

All specialists insist that recovery directly depends on the patient and his desire. To cope with the disease, you need to soberly assess your condition and look for ways to solve the problem. First, the patient has to get rid of illusions, false ideas. And this requires the help of a specialist. It will help the patient to objectively look at the problem, and only after that can we go on to the treatment of the disease itself. Of course, do not forget that neglected, severe disorders can be eliminated much more difficultly or not at all.