The delirious puff

The delirious puff

It is the brutal and transitory appearance of a delirious state (psychotic). One speaks about “clap of thunder in a serene sky”.

The person reached present of many hallucinations (perceptions without object), of the illusions (deformation of the perception of a real object) and interpretations (false deductions of reality). The hallucinations are many, auditive but also psychic (echo of the thought or voice in the head).

The topics of is delirious are numerous: mystics (miraculous visions, divine missions, diabolic possession), erotic or mégalomaniaques. The patients feel suddenly bewitched, épiés or in communication with supernatural forces or robotized.

It is one is delirious which leaves in all the directions and to which one includes/understands nothing. But, the subject is convinced of the reality of sound is delirious. It does not show any criticism and in general is very agitated. It does not take any more time to eat or sleep and sudden of great changes of mood (fast passage of the euphoria to despair).

It is always necessary to eliminate an organic origin in this brutal psychic state. A clinical examination rigorous, in particular neurological, as well as a biological assessment, a urinary search for poisons and a cerebral scanner will be produced in way systematic. Other examinations can be necessary according to the clinical context.

Who is touched?

They are young subjects (15-35 years). There exist readily family psychiatric antecedents but it is not obligatory. Is delirious is often preceded by a stressing event (mourning, separation, marriage, stay abroad, overwork, preparation of examinations) or by a catch of poisons (cannabis, LSD, ecstasy). These external factors could support an important cerebral discharge of certain neuro-transmitters like the dopamine at predisposed individuals.

Which is the treatment?

An acute delirious puff is an urgency. It often imposes the hospitalization of the patient against his liking because this one is not regarded as delirious and refuses the care suggested (law of the 6/27/1990).

The antipsychotic treatments (nerve sedatives) make it possible to make yield is delirious it and can be managed by intramuscular way if the person refuses to introduce them itself by the mouth.

For this emergency period, it is suitable to move away the close relations to prevent that they attend scenes sometimes hard but unfortunately necessary to the treatment of the patient. Once the person is calmer, it is important to deal with the families to explain to them what arrived at their close relation.

After the acute phase, a regular psychiatric follow-up is obligatory even if the person does not present any more any symptom. The treatment will be continued between six months at one year.

If the person presents signs beyond six months, it can be a question of the first episode of a psychiatric disease and a longer-term treatment will be proposed.

And afterwards?

The episode lasts of a few weeks in a few months (by definition, less than 6 months). Then, either he never repeats, or he repeats at the time of a new stress or spontaneously. In this case, it can be a question of a mode of entry in a chronic psychiatric pathology like a psychosis (schizophrenia in particular) or a bipolar disorder.

To retain

The acute delirious puff occurs brutally at an often young individual, without problem up to that point. It is characterized by one is delirious whose topics and mechanisms are numerous. This state requires an urgent psychiatric treatment after having eliminated any physical cause. The episode can remain single or mark the beginning of a psychiatric disease (schizophrenia or bipolar disorder in particular).