The need for humane treatment of the mentally ill people and a legal solution to all issues related to their rights and obligations recognized in ancient times. But the first question of the rights of patients at the state level rose only in the 19th century, when France got the first piece of legislation protecting the rights and interests of the mentally ill.

Legal capacity of citizens

Legal capacity - is the presence of civil rights and obligations, which, in accordance with the law given to man at birth for life regardless of the state of his health. Civil rights give people the opportunity to make different decisions and carry out activities in the private and public life, adhering to the laws of that country.

But in some cases, a person due to their health can not take any decisions and implement actions, then there is the question of depriving it of such a possibility, that is the question of how the person has capacity .  Competence - the ability of a citizen to carry out activities in accordance with its legal capacity .  Only the human capacity may confer rights and impose on it any obligations .  It involves awareness and correct assessment of human actions committed by them from the point of view of the laws of the country, and it depends on the mental maturity of a citizen .  Full capacity comes after the person of age, it is believed that at that age a person reaches mental maturity and acquires the experience that allows mental health to make the right decisions and all actions .

How and why a mentally ill person can be deprived of legal capacity

Mentally ill person has both the legal capacity and capacity to act, and can not be limited to them on the grounds that he is on a dispensary or treated in a psychiatric hospital for mental illness Mental illness - ashamed to ask for help? .

But if, by virtue of his status, he can not make decisions and take responsibility for their actions, it raises the question of deprivation of legal capacity. This decision is made only by the court on the basis of a forensic psychiatric examination.

In order for the court recognized a mentally ill person must be a combination of incompetent medical criterion with the legal, the question is, whether these criteria have that particular patient, responsible forensic psychiatric examination.

Forensic psychiatric examination

Forensic psychiatric examination carried out by order of the law enforcement bodies. It can be conducted on an outpatient basis or in hospital. The basis for the purpose of examination is doubt as to the usefulness of mental citizen.

Mental illness can lead to impotence patient's inability to cater for themselves, there is no critical attitude towards themselves and the surrounding environment. Such a person can not perform their duties, their civil rights, to evaluate their actions. Rate the existence and extent of such changes in a person can only psychiatrist in the forensic psychiatric examination.

The task of the forensic psychiatric examination included the definition of mental health (absence or presence of chronic mental illness, temporary disturbances of mental activity, dementia or another disease state - medical criterion), and the severity of the violation (saved or lack the ability to be aware of their actions, or guide them - legal criterion). The combination of these two criteria is the basis for an opinion on disability.

The validity of any expert solutions is of great social importance. The medical officer shall be an active defender of the legitimate interests of their patients and the public interest, he bears full legal responsibility for knowingly false expert opinion. This is because the decision on the incapacity of completely changing the social status of the patient.

Forensic psychiatric examination conducted forensic permanent commissions, available as part of neuropsychiatric dispensaries. In some cases, when the Commission encountered difficulties in the correct diagnosis, forensic investigative authorities patient is sent for examination to the Institute of General and Forensic Psychiatry. VP Serbian, which establishes the definitive diagnosis and determines the severity of the mental illness.

What the court decides

Court on the basis of the forensic psychiatric examination solves the problem and the strength of a mentally ill person, given that the independent exercise of the patient's rights can apply to him or others serious damage and only recognition of his incapacity and timely appointment of a guardian able to protect the interests of both the patient, and others.

If the court denies the patient's capacity, it loses the right to take any decision and to take any action, and the transactions contemplated by the legislation. An incapacitated person may be subjected to a psychiatric examination, treatment or referral to a mental boarding without their consent. Without his consent to it can be dissolved marriage, his children may transfer to the orphanage or to adopt, and so on.

To the civil rights of the patient are met, the court shall appoint a guardian. While improving the mental condition of the patient as possible through the courts to restore its viability and removal of guardianship.

Galina Romanenko

The most famous is a kind of delirium delirium tremens, which occurs in chronic alcoholism. There is even an expression, "to be drunk delirium tremens," that's just a delirium tremens does not appear on the background of intoxication, and against the backdrop of a hangover when the patient is sober, but he was having persistent metabolic disorders Metabolism: The basis of life of all living things .

What is delirium and its causes

Delirium or delirium syndrome (from the Latin word rave, go crazy) - this dizziness hallucinations, delusions Brad - not only crazy   and motor excitation. But at the same time the patient is always oriented in the self, that is, knows who he is.

Delirium occurs when different kinds of intoxication (eg, chronic alcoholism), severe infections, internal diseases, trauma, vascular lesions and tumors of the brain, after long operations.

The cause of delirium - acute metabolic disorders in the brain, which give rise to stupefaction.

How is delirium

Delirium manifestations increasing gradually passing from one stage to another. In total there are three stages of the disease. At the first stage of the patient in the evening or night there is a general excitement, it is fast, sometimes indiscriminate, hasty movement and fussy, overly expressive facial expression reflects his inner tension or fear. Patients with a lot of talk, but their statements are inconsistent and, at times fragmentary. There are nodules recollections in the form of images, and even scenes. Patients are excited, their usual annoying sounds and lights, the usual food has a more intense flavor and smell. The mood is very changeable: the unreasonable joy tinged with enthusiasm and unbridled joy, the gloomy, moody mood, depression and anxiety.

In the second stage of delirium accompanied by increased sensitivity to all external influences, increased distractibility, the changeable moods and gab occur visual illusions (distorted perception of reality). For example, the patient can take the usual shadows on the wall of the room for some fantastic images. Occasionally may occur violation of orientation at the location and time. Before going to sleep with closed eyes having individual or successive like a kaleidoscope hypnagogic (against the background of falling asleep) hallucinations. Sleep in the first and second stages of delirium shallow, accompanied by multiple bright, often disturbing or nightmares Dreams: how to understand our dreams . Waking up, the patients are not able to understand where was a dream and what was reality.

In the third stage of development, along with the illusions of delirium occur true visual hallucinations (patients see what is really there). The individual pieces of the surrounding part of the hallucinations or serve as a reason to change them.

Hallucinations may be single or multiple, fixed and very dynamic, black-and-white and color, small, normal and enlarged sizes. In some cases, hallucinations are incoherent, in others, they add up to a coherent picture related to the content and scenes. The content of hallucinations has its own characteristics, depending on the cause of the delirium. For example, alcohol and cocaine delirium characterized by hallucinatory images of animals, for delirium on the background of opiate use - very little hallucinatory images. At the same time the patient always gets the audience of his hallucinations, he was surprised, interested, sometimes gripped by fear, or, on the contrary, fun. He looks, running, laughing, defending, hidden, depending on the situation that arises before his eyes.

In the third stage, there may be auditory, tactile (by touch), olfactory hallucinations, delusions sketchy shaped (the patient begins to invent his own version of what is happening). It is usually limited to certain phrases and exclamations. During this period, usually completely disrupted the orientation at the location and time. But orientation in self retained in the patient with delirium always. Sometimes there is a worsening of the third stage, with the appearance of a professional picture or mussitiruyuschego delirium.

The duration of delirium is usually three to seven days. Most often it takes place during sleep. After that usually comes fatigue and depression Depression - a little more than a bad mood .

Professional and delirium mussitiruyuschy

Professional delirium (delirium employment) - Delirium with predominance of monotonous motor excitation in the form of the usual, performed in daily life activities such as control of a motor vehicle, driving nails, cooking. Hallucinations and delusions are minor or absent.

Mussitiruyuschy delirium (quiet delirium) - delirium with monotonous the poor (within the bed) excitation, which is shown taking off, shaking off themselves of something, grasping objects and non-existent in low murmurs, muffled pronouncing certain sounds and interjections.

When professional and mussitiruyuschem delirium prognosis for life and a full recovery is usually poor.

Treatment of delirium - a treatment of the underlying disease, caused it. Treatment of delirium itself - is the removal of medication means excitement and insomnia, and maintenance of the cardiovascular system.

Galina Romanenko