Brike's syndrome – polymorphic hysterical frustration. Meets in two forms: in the form of loss or hoarseness of a voice in combination with unsharply expressed respiratory violations and in the form of numerous and various somatic complaints and symptoms in the absence of pathological changes which could explain displays of a disease. Dramatic character of the anamnesis, frequent to doctors, the need to receive an explanation of symptoms and persistent requirements of medical care is characteristic of the second option of a syndrome of Brike. The diagnosis is exposed on the basis of complaints, the anamnesis and clinical manifestations. Treatment – psychotherapy, pharmacotherapy.
Brique's syndrome – a kind of hysteria at which violations of a voice or multiple somatic symptoms for lack of the objective reasons for emergence of such symptoms are observed. The need for attention in combination with reaction to some difficult transferable vital circumstances is the reason of development of a syndrome of Brique. The name of a syndrome is offered group of the American psychiatrists; it comes from a name of the French psychiatrist Paul Brique who in 1859 published the fundamental work devoted to displays of hysteria. It should be noted that in Brique's monograph is absent the exact description of the syndrome called by his name. Criteria of a syndrome of Brique were defined later when carrying out differentiation of this pathological state with dissotsiativny and conversion frustration.
According to statements of some experts in the field of mental health, suffers from Brike's syndrome about 6% of the patients asking for medical care doctors of various profile. Characteristic of a syndrome are long-term treatment and multiple to different experts. On the structure and clinical manifestations Brike's syndrome is rather close to Myunkhgauzen's syndrome, however differs from it in smaller sensibleness and lack of purposeful actions for simulation of this or that disease. The patient with a syndrome Brike does not understand that he is not sick, he only feels benefit from a disease at the subconscious level. Treatment of a syndrome of Brike is performed by experts in the field of psychiatry.
Reasons of a syndrome of Brike
The reasons of development of frustration are definitely not established. Researchers note that Brike's syndrome is often inherited in the female line. There are data that men in such families usually have psychological problems, quite often suffer from sociopathy and alcoholism. The mechanism of inheritance of a syndrome of Brike is not found out. It is supposed that similar violations can be provoked by genetically caused features of character in combination with the wrong education as a result of which at patients inefficient ways of response to stressful situations are developed.
Typical features of patients with Brike's syndrome are hysterical traits of character, signs of a narcissism and psychological infantility. The egocentrism, the increased suggestibility, immaturity and inconstancy of judgments, an impressionability, emotional instability and easy excitability come to light. Brike's syndrome becomes a peculiar protection against real vital difficulties, allows to draw attention to itself, to provide a careful and caring attitude from people around, to minimize requirements from a family and society.
Symptoms of a syndrome of Brike
The first manifestations of frustration arise at young age. Symptoms of a syndrome of Brike can appear for several minutes or several days or to remain for many months. All signs of a syndrome can be divided into four groups: mental, vegetative, touch and motive. The vegetative symptomatology differs in a big variety, mentions various bodies and systems. Characteristic is beauty of descriptions and dramatic character of clinical manifestations.
Most often at Brike's syndrome symptoms from a GIT come to light: nausea, vomiting, loss of taste, swallowing difficulty, anorexia, stomach pains, dyspepsia, lock and diarrhea. A constant sign is the feeling of a lump in a throat. Less often patients with Brike's syndrome have heartaches, tachycardia, short wind, imaginary pregnancy and vikarny bleedings. In literature there are mentions of a delay of urine, a polyuria, a vaginizm, an aerofagiya, cough, a hiccups, a zevaniye and sneezing.
Among possible motive frustration at Brike's syndrome – paresis, paralyzes, contractures, giperkineza, attacks, various violations of gait and an astasia abasia. The astasia abasia is shown by impossibility to keep balance and to go in the absence of pathological changes from nervous system and the musculoskeletal device. In hard cases of the patient can rise, but falls and cannot take any step, in lungs – balances or it is shaken when walking. Violations of gait at Brike's syndrome can be shown in the form of zigzag gait, gait with a privolakivaniye of legs, stilted gait (on the straightened legs), the sliding gait (reminds the movement of the skater) jumping gait and walking with constantly halfbent knees.
The writing spasm and other frustration complicating performance of professional duties, and also violations of a voice in the form of hoarseness, whisper and an aphonia belong to motive violations at Brike's syndrome. In some cases at patients with Brike's syndrome dumbness, stutter, paralysis and come to light a century. At recruits, especially during conducting combat operations, the kamptokormiya – strong bending of the case in the absence of pathological changes on a backbone X-ray analysis can be found.
Variability, instability, dependence on an emotional state and combination to other vegetative or motive symptoms is characteristic of giperkinez at Brike's syndrome. Unlike epileptic attacks attacks at Brike's syndrome arise in the psychoinjuring circumstances, in the presence of other people. Alternation of clonic and tonic phases is broken, duration of an attack is increased, consciousness is kept, loss of memory after an attack is absent.
Touch frustration at Brike's syndrome represent pain, decrease, absence or increase in sensitivity. Headaches, articulate pains, belly-ache or a back can disturb the patient. Skin sensitivity is broken as stockings or gloves, at the same time discrepancy between the fields of violation of sensitivity and zones of an innervation comes to light. Sometimes at Brike's syndrome there are deafness or a blindness.
Mental disorders are shown in the form of amnesia, illusions and hallucinations. Behavior of patients artificial, demonstrative, theatrical. The story about symptoms turns into the tragedy, demonstration of displays of a disease – into representation. The mistrust to words of the patient with a syndrome Brike causes children's offense; admiration and delight before the doctor as before "the unique, best expert" can quickly be replaced by indignation, irritation and even hatred. Patients with Brike's syndrome can think up something, and then believe in the history and sincerely be perplexed when people around point by it to discrepancy. Their claims are overestimated, they expect from the world more, than can receive according to the abilities and opportunities. They prefer to pretend, "to create the beautiful picture", but not to perform active operations on change of reality according to the requirements.
Diagnostics and treatment of a syndrome of Brike
The diagnosis is exposed on the basis of the anamnesis, complaints and a clinical picture. As signs of a syndrome of Brike numerous complaints to violations from various bodies and systems which for the first time appeared aged are considered 30 years are younger and remained (or disappeared, and then again appeared) for many years. Besides, constant searches of treatment, violation of working capacity, social or personal activity, absence of the somatic diseases explaining pathological manifestations, and denial of absence of a disease are characteristic of Brike's syndrome. In the course of inspection exclude somatic pathology, at the same time it is important not to follow the tastes of the patient and not to appoint unnecessary researches.
Treatment of a syndrome of Brike represents a complex challenge. Use of medicines and a razubezhdeniye are ineffective. Purpose of placebo leads to reduction or disappearance of symptoms within 1-2 months. Then already existing symptoms of a disease come back or new appear. In attempt to dissuade the patient available of a somatic disease of manifestation of a syndrome of Brike become more expressed. According to indications appoint antidepressants, carry out long individual psychotherapy.