There are several forms of negativism. With passive negativism, the patient does not fulfill requests made to him, and during external interventions - an attempt to feed him, change clothes, examine him, etc., he resists, accompanied by a sharp increase in muscle tone. Active negativism is accompanied by performing other actions instead of the proposed ones or directly opposite ones. Speech impairment during catatonic stupor can be expressed by mutism - the absence of verbal communication between the patient and others while the speech apparatus is intact. Patients with catatonic stupor often find themselves in characteristic postures. in a position lying on one's side, in a fetal position, standing with the head bowed and arms extended along the body, in a squatting position. Some patients pull a robe or blanket over their heads, leaving their face open - a symptom of a hood (P.A. Ostankov, 1936).
Catatonic stupor is accompanied by somatic disorders. Patients lose weight and may experience symptoms of vitamin deficiency. The extremities are cyanotic, and swelling is noted on the dorsum of the feet and hands. Erythematous spots appear on the skin. There are constant violations of secretory functions. drooling, increased sweating, seborrhea. The pupils are constricted. In some cases, there is a lack of reaction of the pupils to painful stimuli. Blood pressure is reduced.
HEBEPHRENIC SYNDROME - a combination of motor and speech excitation with foolishness and changeable affect. Motor excitement is accompanied by clowning, antics, grimacing, and clownish copying of the actions and words of others. Using hospital clothes, newspapers, etc., patients come up with extravagant outfits for themselves. They pester others with inappropriate or cynical questions, and try to interfere with them in some way, throwing themselves under their feet, grabbing clothes, pushing and pushing them aside. Excitement may be accompanied by elements of behavioral regression. Thus, patients refuse to sit down to eat at the dinner table and eat while standing; in other cases, they climb onto the table with their feet. They eat without using a spoon, but grab food with their hands, slurp, spit, and burp.
Patients are either cheerful, laughing and cackling out of place, then they begin to whine, squeal, sob or howl, or they become tense, angry and aggressive. Speech is often incoherent to one degree or another, and may be accompanied by neologisms, the use of rarely used words and phrases that are pretentious in construction, and echolalia. In other cases, patients sing obscene ditties or use foul language. In the structure of hebephrenic syndrome, unstable hallucinatory and delusional disorders occur. Catatonic symptoms are often observed. If they are constant, they speak of hebephrenic-catatonic syndrome.
Clinical definitionThere is no definition of the term “stupidity”. There are only psychological, physiological and philosophical definitions of consciousness. The difficulty of clinical definition is due to the fact that this term unites syndromes that are very different in their characteristics.