Raptus

RAPTUS, excitement, acute agitation caused by an excessively strong depressive affect (melancholy, fear). In contemporary psychiatric literature, only R. melancholicus is discussed. Under this term are understood states that most often develop in circular depression and are usually characterized by motor restlessness accompanied by an irresistible urge to commit violent acts. An attack of Raptus melancholicus can occur suddenly when the patient is in a relatively tolerable state, or it develops through a gradual intensification of the depressive affect characteristic of the disease. It usually begins with the so-called precordial melancholy, i.e., unbearable psychic pain accompanied by an extremely severe painful sensation in the area of the heart. This pain quickly becomes unbearable, and the patient begins to moan and toss about. He begs for help, tears out his hair and clothing, beats himself, bangs his head against the wall, and tries to end his life in one way or another. Consciousness at this time may be unclear, but more often it is sharply narrowed and filled with gloomy thoughts corresponding to the affect, often of a delusional character. The patient's face usually turns pale, cardiac activity becomes irregular, sometimes sweat appears and trembling begins throughout the body. The attack usually lasts for several hours, rarely days (in the latter case with alternating intensifications and remissions), and ends with a return to the state preceding it. Therapeutic measures sharply terminate the attack and most often consist of measures to protect the patient. To alleviate the condition, long warm baths and large doses of potent sleeping drugs are used.