Импульсивная агрессия: распознавание и выбор фармакотерапии
- Авторы: Снедков Е.В.1,2
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Учреждения:
- Психиатрическая больница св. Николая Чудотворца
- Северо-Западный государственный медицинский университет им. И.И. Мечникова
- Выпуск: Том L, № 1 (2018)
- Страницы: 77-91
- Раздел: В помощь практическому врачу
- Статья получена: 23.12.2022
- Статья одобрена: 23.12.2022
- Статья опубликована: 10.05.2023
- URL: https://journals.eco-vector.com/1027-4898/article/view/119902
- DOI: https://doi.org/10.17816/nb119902
- ID: 119902
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Аннотация
Инструментальная (управляемая) агрессия наблюдается в популяциях психически здоровых и психически больных. Она не связана со специфической патофизиологией и не может расцениваться в качестве самостоятельного симптома, который мог бы служить мишенью патогенетической терапии. Напротив, импульсивная агрессия представляет собой пароксизм гнева на фоне аффективно суженного сознания с резким ослаблением или полной утратой волевого контроля. От родственной компульсивности импульсивность отличается выпадением этапа интеллектуальной переработки аффективно окрашенных представлений и непроизвольной, автоматической реализацией иррационального влечения к действию. Пациентов, проявляющих импульсивную агрессию, объединяет паттерн нейробиологических аномалий в виде дефицита лобной ингибиции подкорковых аффектов и влечений при воздействии релевантных возбуждающих стимулов. Обобщены результаты доказательных исследований, мета-анализов и Кокрейновских обзоров эффективности фармакологических средств, применяемых в целях редукции импульсивной агрессии.
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Об авторах
Евгений Владимирович Снедков
Психиатрическая больница св. Николая Чудотворца; Северо-Западный государственный медицинский университет им. И.И. Мечникова
Автор, ответственный за переписку.
Email: esnedkov@mail.ru
кафедра психиатрии и наркологии
Россия, 190121, Санкт-Петербург, наб. реки Мойки, д. 126; Санкт-ПетербургСписок литературы
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