Kandinsky-Clerambo syndrome (otherwise - a syndrome of mental automatism, hallucinatory-paranoid syndrome) is a painful mental condition characteristic of paranoid schizophrenia. Description and study of this mental disorder belongs to the great Russian psychiatrist Viktor Khrisanfovich Kandinsky and the French doctor Clerambo.
Kandinsky’s feat of life lies in the fact that, suffering from this disease, he found the strength to explore his own ailment, having examined all its details in the smallest details. Currently, the diagnostic criteria for schizophrenia are deeply related to the clinical description of Kandinsky.
Kandinsky-Clerambo syndrome is characterized by delusions of persecution and exposure, a group of psychic automatisms and pseudo-hallucinations.
About the delusions of harassment and exposure
Its content is very diverse. The patient believes that he is being persecuted and various external factors act on him, from witchcraft and hypnotic influences to the methods of modern technology and technology, sophisticated equipment, laser beams, atomic energy, radiation, etc.
About psychic 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 thoughts, actions, movements, sensations - all this is “done” outside of him.
According to the patient, various types of energy that affected him took possession of his life.
There are 3 types of psychic automatisms:
- ideators;
- sensory (senestopathic);
- motor (kinesthetic).
Automatisms are not always presented at the clinic immediately together, but the sequence of their appearance is exactly as given below.
Ideological automatisms are called the mistakenly imagined by the patient violent effect on his thought processes.
Their first manifestation is the phenomenon of mentism : thoughts flow non-stop, often too quickly, in some cases they are accompanied by unaccountable anxiety.
Then a symptom of openness appears: the patient feels that his thoughts are available for "reading" to absolutely everyone around him. It cannot appear in crowded places (in a bus, in a company), since even the most secret and intimate thoughts are “read”.
The distortion of the thought process also belongs to the group of ideational automatisms. The phenomena are noted:
- “rustling” of thoughts: they “speak out in the head” of the patient all together, in a whisper and inaudible, their flow cannot be stopped;
- “sounding” thoughts: no matter what the patient thinks, everything sounds clearly and loudly inside his head;
- “echo of thoughts”: all that others say is a repetition of the patient’s thoughts.
Further, Kandinsky-Clerambo syndrome dictates the development of ideational automatism with the following phenomena:
- "taking away" thoughts: suddenly the patient discovers in his head a traceless loss of thoughts that have just been there;
- “made” thoughts: the patient is convinced that all his thoughts are “made” by the ill-wishers who pursue him;
- “made” dreams: the patient suffers from unpleasant dreams that are caused by external force;
- “unwinding” memories: not by their own free will and desire, under the influence of frightening alien factors, patients are “forced” to recall various episodes from their lives. As an illustration of these recollections, patients are "shown paintings";
- “made” mood, “made” feelings: the patient claims that the cause of his dislikes and sympathies, moods and feelings is an outside influence.
Senestopathic (sensory) automatisms are complexes of sensations arising in a patient due to the imaginary effect of external forces. These complexes also seem to the patient to be “done” and are painfully unpleasant for him. For example: suddenly there is a cold or heat, vague pains occur in the internal organs (including those that, in principle, can not hurt). Many of these sensations are distinguished by pretentiousness and unusualness - for example, bursting, pulsation, twisting.
Kinesthetic (motor) automatisms are mental disorders in which the patient is convinced: in addition to his will, all the movements that he makes are created by means of imposed force. According to the patient, something or someone from outside makes his limbs move or, on the contrary, plunges them into a stupor.
Speech-motor automatisms also belong to motor ones. Patients believe that an unknown force moves their tongue to pronounce words and phrases. The patient does not recognize himself as the author of the words that he says. Their real masters are the persecutors of the patient.
About pseudo-hallucinations
The main feature of pseudo-hallucinations is that they are perceived by the patient as “not their own”, not being identified with objects of reality (unlike true hallucinations, in which the patient is sure that they are reality).
Hallucinations are always projected into the outside world. They live only "outside" in relation to the psyche. Pseudo-hallucinations can remain "inside the head." For them, the “internal gaze” as an instrument of consideration is quite normal.
The patient always considers pseudo-hallucinations “caused” by an external cause.
Kandinsky-Clerambo syndrome includes a group of the following pseudo-hallucinations:
- visual;
- auditory;
- olfactory;
- flavoring;
- tactile;
- visceral;
- kinesthetic.
Visual pseudo-hallucinations include the perception of faces, images, visions, paintings that are “demonstrated” to the patient by his persecutors using “special methods”.
Auditory pseudo-hallucinations are a group of noises, words, phrases that are transmitted to the patient "by radio, using various equipment", etc.
Clerambo syndrome combines pseudo-hallucinations into groups of imperative (volitional) and commentators . All types of “voices” are presented: male and female, children's belonging to friends and strangers.
As for the pseudo-hallucinations of olfactory, gustatory, tactile, visceral and kinesthetic ones, it makes no sense to describe them, since they coincide in their signs with the corresponding classical hallucinations. The only significant difference, as already mentioned, is that all pseudo-hallucinations appear to the patient to be "made" outside of himself.
The treatment of Kandinsky-Clerambo syndrome consists in combined therapy with psychotropic drugs (Triftazin, Haloperidol) and psychotherapy, followed by a rehabilitation course.
Since the paranoid schizophrenia to which this syndrome belongs recurs, the prognosis is poor. However, a direct observer and pioneer of the syndrome V. Kh. Kandinsky indicates (in accordance with personal experience) the presence of periods of persistent remission.