Mutism ( lat. Mutus - mute, mute) - in psychiatry and neurology, a condition where the patient does not answer questions and does not even make it clear with signs that he agrees to make contact with others [1] , while in principle the ability to talk and understand the speech of those around him is preserved [2] . With mutism, there is no response or spontaneous speech. Mutism should be distinguished from aphasia , in which the ability to speak is also lost, usually due to some kind of brain damage. If the patient does not speak, but at the same time he retains the ability to write, he is likely to mutism, but not aphasia [3] .
| Mutism | |
|---|---|
| ICD-11 | MB23.D |
| Mesh | and |
It can flow into logophobia and logoneurosis .
Content
Mutism Options
The following variants of mutism are distinguished [2] :
- psychogenic mutism (this type of mutism may occur in children as an acute reaction to mental trauma , or in certain social situations that cause fear and anxiety );
- catatonic mutism (with catatonic syndrome , mutism due to unmotivated and without external reasons counteraction to the urge to communicate);
- hysterical mutism (usually caused by the patient's unconscious and suppressed desire to draw the attention of people around him to the loss of the ability to speak).
- akinetic mutism (organic; usually occurs with organic brain lesions: with gunshot wounds of the frontal sections, hemangiomas of mesencephalic localization, basilar artery thrombosis, tumors in the region of the third ventricle [4] ).
Selective / elective / selective mutism is also highlighted - when the patient conducts a conversation only with a selected circle of people and only in certain situations. This type of mutism also occurs in childhood, more often at the age of 3 years or from the beginning of school, and is manifested in communication only with selected people (most often the child contacts all members of the family, except one) [4] . This type of mutism is included in the medical classifiers DSM-5 and ICD-10 as a separate diagnosis, the code is F 94.0 .
Mutism-related diseases
Mutism is a symptom of psychomotor disorder, can occur after concussion and bruising of the brain, severe mental trauma , fire, death of loved ones, as one of the late manifestations of the AIDS- dementia syndrome complex, etc. Catatonic mutism occurs in catatonic schizophrenia due to negativity . Hysterical - with dissociative (conversion) disorders and hysterical personality disorder . Mutism can also develop in neurological diseases, for example, with bilateral lesion of the cortico-bulbar tract, paralysis of the vocal cords and severe spasticity [3] .
Treatment
Features of caring for patients with mutism are that the nurse should maintain constant communication with such patients using facial expressions, writing, gestures. Conversations in combination with means that stimulate the activity of the nervous system are very useful and completely relieve deafness and dumbness.
For the treatment of mutism, according to the doctor's prescription, the method of disinhibition is used. After injection of 1 ml of a 10% caffeine solution, after 3-5 minutes the patient is injected very slowly (1 ml / min) with amobarbital solution until a state of mild intoxication appears. As a rule, one procedure is enough. Concluding the procedure, the nurse should make the patient answer questions and enter into a conversation with him several times during the treatment day.
In society and in religion
It should not be attributed to the manifestations of mutism known in a number of social classes and in religion forms of behavior associated with a vow of silence . For example, after some traumas that are considered shameful , shameful by society ( rape , stigmatization as a “public enemy ”, etc.), the society announces a boycott (in Judaism as a cherom ) of the guilty person, subsequently receiving a similar response from the person or person she makes such a decision herself; a similar situation can be in those cases when a person begins to consider his whole life sinful for religious reasons. The result may be removal to a hermit or monastery with many years of silence by personal or social decision.
See also
- Deaf mute
- Deafness
- Deafness
- All-Russian Society of the Deaf
Notes
- ↑ M.V. Korkina, N.D. Lakosin, A.E. Lichko, I.I. Sergeev. Psychiatry: A Textbook for Stud. honey. universities. - M .: MEDpress-inform, 2006 .-- 576 p. - ISBN 5-98322-217-1 .
- ↑ 1 2 Zhmurov V.A. Mutism // Big Encyclopedia of Psychiatry. - 2nd ed.
- ↑ 1 2 Ed. E.I. Guseva, A.N. Konovalova, V.I. Skvortsova, A. B. Geht. Neurology: national leadership . - GEOTAR-Media, 2010. - P. 31. - ISBN 978-5-9704-1714-0 .
- ↑ 1 2 V.M. Bleicher, I.V. Kruk. Explanatory Dictionary of Psychiatric Terms. - MODEK, 1995. - ISBN 5-87224-067-8 .
Literature
- Nervous diseases: a textbook / M. N. Puzin, A. V. Stepanchenko, L. G. Turbina, etc. under the editorship of M.N. Puzin. - M.: Medicine, 1997.