Russian psychiatry: Kandinsky-Clerambo syndrome

The Kandinsky-Clerambo syndrome (otherwise - the syndrome of mental automatism, hallucinatory-paranoid syndrome) is a morbid mental state, characteristic of paranoid schizophrenia. The description and research of this mental disorder belongs to the great Russian psychiatrist Victor Khrisanfovich Kandinsky and the French doctor Clerambo.

Kandinsky's life feat is that, suffering from this disease, he found the strength to explore his own ailment, considering in minute detail all of his details. Currently, the diagnostic criteria for schizophrenia are deeply associated with the clinical description of Kandinsky.

The Kandinsky-Clerambo syndrome is characterized by delusions of persecution and influence, a group of psychic automatisms and pseudo-hallucinations.

About the burden of persecution and influence

Its content is very diverse. The patient believes that he is persecuted and various external factors act on him, from witchcraft and hypnotic influences to methods of modern technology and technology, complex equipment, laser beams, atomic energy, radiation, etc.

About mental automatisms

The patient is convinced that he is influenced by insidious external forces. As a result of this influence, the patient ceases to belong to himself. He no longer has his own thoughts, actions, movements, sensations - all this is "done" outside of him.

According to the patient's view, the various types of energy that were influenced by him took possession of his life.

There are 3 types of mental automatisms:

• Ideal;
• Sensory (senestopatic);
• Motor (kinesthetic).

Not always the automatisms can be presented together in the clinic, but the order of their appearance is exactly the same as the following text.

Ideal automatism is the mistakenly imagined patient's violent impact on his thought processes.

Their first manifestation is the phenomenon of mentism : thoughts flow non-stop, often too quickly, in a number of cases they are accompanied by an unaccountable alarm.

Then a symptom of openness manifests itself: the patient feels that his thoughts are available to "read" absolutely to everyone around him. He can not appear in crowded places (on the bus, in the company), because even the most secret and intimate thoughts are "read".

Distortion of the thought process also belongs to the group of ideal automatisms. The following phenomena are noted:

- "rustle" of thoughts: they "talk through the head" of the patient all together, in a whisper and illegible, their flow can not be stopped;

- "sounding" thoughts: whatsoever the patient thinks - everything clearly and loudly sounds inside his head;

- "echo of thoughts": everything that others say is a repetition of the patient's thoughts.

Further, the Kandinsky-Clerambo syndrome dictates the development of ideator automatism with the following phenomena:

- "taking away" thoughts: suddenly the patient discovers in his head the traceless disappearance of thoughts that were just there;

- "made" thoughts: the patient is convinced that all his thoughts are "made" by ill-wishers who pursue him;

- "made" dreams: the patient suffers from unpleasant dreams, which are caused by an external force;

- "unwinding" memories: not by their own will and desire, under the influence of frighteningly alien factors, patients are "forced" to recall various episodes from their lives. As illustrations to this memory, patients "show pictures";

- "made" mood, "made" feelings: the patient claims that the cause of his antipathies and sympathies, moods and feelings is extraneous influence.

Sensostatic (sensory) automatisms are the complexes of sensations arising in the patient due to the imaginary influence of external forces. These complexes also seem to the patient "made" and are painfully unpleasant for him. For example: suddenly there comes a cold or a fever, vague pains arise in internal organs (including those that in principle can not be sick). Many of these sensations are fanciful and unusual - for example, bursting, pulsating, twisting.

Kinesthetic (motor) automatisms are mental disorders, in which the patient is convinced: in addition to his will, through the imposed force, all the movements that he makes are created. According to the patient, something or someone from the outside forces his limbs to move or, on the contrary, immerses them in a stupor.

Motor-related automatisms are also referred to motor. Patients believe that an unknown force moves their tongue, so that they utter words and phrases. The patient does not recognize himself as the author of the words that he speaks. Their real owners are the persecutors of the patient.

About pseudohallucinations

The main feature of pseudo-hallucinations is that they are perceived by the patient as "not their own", not being identified with the objects of reality (as opposed to true hallucinations, in which the patient is sure that they are reality).

Hallucinations are always projected into the external world. They live only "outside" in relation to the psyche. Pseudohallucination can remain "inside the head". For them, the "inner look" as a review tool is quite normal.

The patient always considers pseudo-hallucinations to be "caused" by an external cause.

The Kandinsky-Clerambo syndrome includes a group of the following pseudo-hallucinations:

• Visual;
• Auditory;
• Olfactory;
• Flavoring;
• Tactile;
• Visceral;
• Kinesthetic.

The visual pseudo-hallucinations include the perception of persons, images, visions, pictures, which are "demonstrated" to the patient by his pursuers with the help of "special methods".

Auditory pseudo-hallucinations are a group of noises, words, phrases that are transmitted to the patient "on the radio, with the help of various equipment," etc.

Syndrome Clerambo unites pseudo-hallucinations into groups of imperative (willful) and commenting . Presented are all types of "voices": male and female, children's, belonging to familiar and unfamiliar people.

As for pseudo-hallucinations of the olfactory, taste, tactile, visceral and kinesthetic, they do not need to be described, since they coincide in their characteristics with the corresponding classical hallucinations. The only significant difference, as already mentioned, is that all pseudo-hallucinations seem to the patient "made" outside himself.

Treatment of Kandinsky-Clerambo syndrome consists in combined therapy with psychotropic drugs (Triftazin, Haloperidol) and psychotherapy, followed by a rehabilitation course.

Because the paranoid schizophrenia to which this syndrome belongs, recurs, the prognosis is malogamous. However, the direct observer and the discoverer of the syndrome V. Kh. Kandinsky points (in accordance with personal experience) for the existence of periods of persistent remission.