Psychomotor agitation

1. An acute reaction to stress in mentally healthy individuals in extreme situations ( reactive psychosis ). It occurs immediately after a mental trauma. It is expressed by motor anxiety of varying severity (from monotonous monotonous excitement with inarticulate sounds to the picture of senseless excitement with a stampede, self-harm , suicide ). Often excitement is replaced by a stupor.
2. Acute stages of infectious diseases with CNS intoxication with toxins of bacteria , viruses .
3. Brain lesions: traumatic brain injury , progressive paralysis .
4. Epilepsy - epileptic agitation occurs with twilight disorder of consciousness in patients with epilepsy (an anamnesis is important). It is characterized by a sudden beginning and an equally sudden end, accompanied by anger, aggressiveness, complete impossibility of contact. Extremely dangerous to others, as they destroy everything that occurs on the way.
5. Acute and chronic intoxication , including atropine , alcoholic , alcoholic psychosis or delirium tremens .
6. Delirium is a hallucinatory confusion with a predominance of visual hallucinations , accompanied by figurative delirium (delirium is a false conclusion that does not correspond to reality, arising from the disease), a sense of fear, tremor , tachycardia , sweating, low-grade fever, hyperreflexia .
7. Hypoxia and toxic brain damage in precomatous and coma states of various etiologies.
8. Hysteria . It is a response to an external irritating factor, however, the cause that caused it does not correspond to the strength of the response, which is associated with the psychological characteristics of the nature of the patients. Excitation with viciousness, aggressiveness is addressed to specific individuals who offended the patient. Characteristic is the demonstrative behavior of the patient, his desire to attract the attention of others, cause their sympathy or approval. Patients cry, scream, wave their hands, there may be aggressive actions against others, as well as demonstrative suicidal attempts .
9. Mental illness:
   • Depressive psychosis - develops in patients with depression with a sharp increase in depressive experiences in the form of increasing unbearable melancholy, hopelessness, despair. Patients rush about, moan, howl, persistently inflict damage on themselves, actively seek suicide;
   • Manic excitement - a quick change of mood from fun to anger, fussiness, patients do not sit still, intervene in everything, take on many things, not a single one ending. Sometimes ideas of greatness. With objections, patients become angry;
   • Schizophrenia ;
   • Bipolar affective disorder .

The mechanism of development of psychomotor agitation is complex, different in different diseases.
Depending on the disease, they play a role:

• Metabolic disease
• Neuroreflex mechanisms
• Immune and autoimmune reactions
• Direct toxic effect of various poisons
• Brain ischemia
• Psychological characteristics of personality

The main thing in the clinic is an increase in mental and motor activity.

• The course of the disease is always acute
• There is a violation of consciousness, which can manifest as delirium , confusion ( twilight consciousness ), delirium .
• Thinking accelerated, torn (dissociative)
• There may be illusions and hallucinations
• There is no criticism of his condition. Euphoric mood (increased) (hyperthymic mood)

• Immediate hospitalization in a psychiatric hospital and isolation of the patient. If necessary, its fixation (tying, tying to bed, using a straitjacket), as these patients are dangerous to others.
• The use of tranquilizers and antipsychotics : haloperidol , chlorpromazine , hydrochloride , diazepam , sodium oxybutyrate , tizercin , chlorprotixen . In severe psychomotor agitation in manic or psychotic patients, it is recommended that tranquilizers phenazepam , diazepam, lorazepam or clonazepam be combined with antipsychotics and lithium preparations ^[1] .

The weakening of arousal, temporary reassurance of the patient should not reduce the intensity of treatment and observation of the patient, since the arousal can resume with the same force.

• Agitation

• Psychomotor agitation on the site medikk.ru
• Psychomotor agitation Per. from English N. D. Firsova (2019)
• The level of excitation processes. Questionnaire of temperament Ya Strelya online