What is neurosis?

Although everyone seems to be familiar with the disease of mental disorder, if you ask them to describe it in detail, they don’t know where to start. In fact, mental disorder is a mild disorder of consciousness. The patient will be obsessed with fantasy and unable to clearly distinguish the outside world. For diseases like mental disorders, patients can easily recover as long as they receive proper treatment and guidance.

Mental disorder (amentia, feeling-mindedness) is also called delirium. The patient has a mild disorder of consciousness. Because he tends to fantasize, he cannot distinguish between the outside world and his own state. He can still be aware of his own thinking, but it lacks systematicity and because of incoherent speech, he is naturally in a state of confusion. If the disease progresses, the patient will talk nonsense, and if the disease is mild, he will tend to hallucinate. People generally retain some degree of memory of what happened during this period. In the United Kingdom, the term psychosis is often used to mean mental frailty, a clinical condition characterised by fluctuating disturbances in cognition, emotion, attention, arousal and self-perception, which may develop acutely without prior intellectual disability or may occur in addition to chronic intellectual disability.

Symptoms are usually reversible if the underlying cause is promptly identified and treated appropriately, particularly if the cause is hypoglycemia, infection, iatrogenic factors, drug toxicity, or electrolyte disturbances. However, recovery may be slow (days or even weeks or months), particularly in elderly cases.

All nonessential medications should be discontinued. Identified etiologies should be treated, with fluid and nutrient supplementation. Patients suspected of alcoholism or alcohol withdrawal should be given thiamine 100 mg intramuscularly daily for at least 5 days to ensure absorption. During hospitalization, such cases should be closely monitored for signs of withdrawal, which may manifest as autonomic dysfunction and worsening signs of psychosis.

The environment should be kept as quiet and peaceful as possible, and the lighting should be dim but not completely dark. Medical staff and family members should reassure patients, strengthen their directional judgment, and explain various operations in a timely manner. Avoid giving excess medication unless it is necessary to treat the underlying cause. However, sometimes symptomatic treatment is necessary when agitation symptoms could endanger the safety of the patient, caregivers, or medical staff. Proper restraints can help prevent patients from disconnecting IV or other treatment lines. Physical restraints should be applied by trained personnel; they should be removed every 2 hours to prevent injury and as soon as symptoms improve.

There is currently little scientific information to guide the selection of drugs for the treatment of delirium. Small doses of haloperidol (0.25 mg orally, IM, or IV) or thioridazine (5 mg orally) can be helpful in managing cases of delirium. Sometimes larger doses are needed (haloperidol 2 to 5 mg or thioridazine 10 to 20 mg). Newer drugs, such as risperidone, may replace oral haloperidol, but they are not currently available for IM or IV administration. Short-acting or intermediate-acting benzodiazepines (eg, alprazolam, triazolam) can temporarily control agitation symptoms; benzodiazepines may worsen symptoms of psychosis, so when they are needed, they should be started at the lowest effective dose. All medications used to treat psychosis should be reduced in doses and discontinued early to allow assessment of recovery.