Cognitive personality disorders arespecific disorders occurring in the cognitive sphere of the individual and including the following symptoms: a decrease in memory, intellectual performance and a decrease in other cognitive processes of the brain in comparison with the personal norm (the initial level) of each individual. Cognitive or cognitive functions are the most complex processes that result from the brain. With the help of these processes, rational comprehension of the surrounding world, interaction and interaction with it, characterized by purposefulness, are realized.
Cognitive functions include: perception (reception) of information, processing and analysis of data, their storage and subsequent storage, data exchange, development and implementation of an action plan. Causes of cognitive disorders can be a variety of ailments that differ in the mechanisms and conditions of occurrence, the course of the disease.
Causes of Cognitive Disorders
Cognitive impairment is by its naturefunctional and organic. Functional disorders in the cognitive sphere are formed in the absence of direct brain damage. Overwork, stress and constant overstrain, negative emotions - all this can cause functional cognitive disorders. Functional disorders of the cognitive sphere can develop at any age. Such disorders are not considered dangerous and always disappear or their manifestations diminish substantially after the elimination of the cause of the disturbances. However, in some cases, the use of drug therapy may be required.
Organic states in the cognitive sphereThey occur as a result of damage to the brain as a result of diseases. They are more common in older people and usually have more stable traits. However, the right therapy, even in these cases, helps to achieve improvement in the condition and prevents the growth of disturbances in the future.
The most frequent causes of organic pathologies in the cognitive sphere are: lack of blood supply to the brain and an age-related decrease in brain mass or atrophy.
Insufficient blood supply to the brain canto attack due to hypertension, cardiovascular pathology and strokes. Therefore, it is very important to timely diagnose these diseases and correct their treatment. Otherwise serious complications can arise. Arterial pressure, maintaining the sugar level in the norm and cholesterol in the blood should be given special attention. There are also vascular cognitive disorders that develop due to chronic brain ischemia, repeated strokes or a combination of these. Such pathologies are divided into two variants: disorders that arise as a result of the pathology of small vessels, and disorders due to the pathology of large vessels. Neuropsychological features of the detected states, reflecting their interrelation with the disturbance in the work of the frontal lobes of the brain, will testify to the vascular etiology of cognitive disorders.
Vascular cognitive personality disorders today are quite common in the practice of neurological pathologies.
At an atrophy of a brain, owing to age changes, more expressed pathologies of cognitive functions are formed. This pathological condition is called
and is considered a progressive disease. However, the rate of increase in pathologies in the cognitive sphere can vary considerably. Predominantly, the symptoms are characterized by a slow build-up, so that patients can maintain independence and independence for many years. An adequate value for such patients is provided by adequate therapy. Modern methods of therapy help to achieve improvement in the patient's condition and long-term stabilization of manifestations.
Also the causes of pathologies in the cognitive spherethere may be other brain diseases, cardiovascular insufficiency, diseases of internal organs, impaired metabolism, alcohol abuse or other poisoning.
Symptoms of cognitive disorders
The disorder of cognitive functions is characterized byspecific symptomatology, which depends on the degree to which the pathological process is expressed, and what parts of the brain it affects. The defeat of individual sites causes violations of individual cognitive functions, but still more often a disorder of several immediately or all of the functions.
Disorder of cognitive functions causesdecrease in mental efficiency, memory impairment, difficulty expressing one's own thoughts or understanding someone else's speech, worsening concentration. In severe disorders, patients can not complain about anything because they lose their criticality to their own condition.
Among the pathologies of the cognitive sphere the most frequenta memory impairment is considered a symptom. At first, progressive disturbances arise in the memorization of recent events, and gradually and distant events. Along with this, mental activity can decline, thinking can be broken, and as a consequence
can not correctly assess information, deterioratesability to generalize data, draw conclusions. Another not less common manifestation of cognitive impairment is the worsening of concentration. Individuals with such manifestations find it difficult to maintain vigorous mental activity, to concentrate on specific tasks.
Under the concept of mild cognitive disordersindividuals usually imply a disruption in the work of one or more cognitive processes that go beyond the limits of the age norm, but that do not reach the level of expression
. Moderate cognitive impairment, the mainimage, are considered a pathological condition, the result of which transformations at this stage are not exhausted only by age-related involutive processes.
According to a number of studies,the syndrome of moderate cognitive disorders is observed in 20% of individuals older than 65 years. Studies also show that dementia develops in 60% of individuals with this pathology within five years.
Moderate cognitive disorders in 20-30%cases are stable or sluggishly progressive, that is, they do not translate into dementia. Such disorders are able to remain undetected by individuals for quite some time. However, if several symptoms are detected in a short period of time, then it is worthwhile contacting specialists for advice.
On the presence of cognitive impairmenttestify to the following symptoms: difficulties in performing routine counting operations, difficulties with repetition of the information just received, violation of orientation in unfamiliar terrain, difficulties in memorizing people's names, new ones in the environment, obvious complications in the choice of words in ordinary conversation.
Moderate cognitive disorders, identified in the early phases of its development, can be quite successfully corrected with the help of medications and various psychological techniques.
In order to assess the severity of cognitive impairmentspheres special neuropsychological testing is used, which consists in answering a number of questions and performing certain tasks by the patient. In accordance with the results of testing, it becomes possible to determine the presence of deviations of certain cognitive functions, as well as their severity. Test tasks can be in the form of simple mathematical actions, such as adding or subtracting, writing something on paper, repeating a few words, determining the items shown, etc.
Mild cognitive impairment
The dodement state is a lightcognitive impairment. In other words, mild violations of cognitive functions are pathologies of the higher functions of the brain, characterized primarily by vascular dementia, passing through a number of stages in their development, determined by a gradual increase in symptoms - beginning with mild violations of the functions of the cognitive sphere, mainly memory, and ending with severe impairment - dementias.
According to the recommendations of the internationalclassification of diseases, diagnosis of mild cognitive impairment is possible in the presence of the following symptoms: impairment of memory function, attention or loss of ability to learn, while performing mental work there is a high fatigue. In this case, the disorder of the memory function and the disruption of the work of other brain functions does not lead to atrophic dementia and does not have a connection with
. These disorders have a cerebrovascular origin.
Clinical manifestations of this disordercorrespond to a stable cerebrosthenic syndrome, which in fact refers to psychopathological conditions, reflecting the violation of various areas of the psyche, including cognitive functions. However, in spite of this cerebrosthenic syndrome is characterized by external safety of patients, absence of severe disorders of mental, critical and prognostic processes, illusion of instability, patency of asthenic disorders.
Diagnosis of this disorder is based on the results of clinical examinations and the conclusions of the experimental psychological study.
An easy cognitive disorder is differentiatedfrom organic disorders in that violations in the work of the cognitive sphere do not result in a combination with emotional (affective instability), productive (! paranoia) and behavioral disorders (inadequacy).
Cognitive disorder in children
Development of cognitive functions for the most part depends on the provision of the human body with vitamins and other useful substances.
Today, unfortunately, it becomes quite acutethe problem of hypovitaminosis in children. The use of refined food products, products of long-term storage, goods that have been subjected to prolonged temperature treatment, leads to the impossibility of replenishing the necessary quantity of essential micronutrients only with the help of a diet.
According to recent yearsstudies of the vitamin and mineral state of children's organism, we can conclude that the lack of ascorbic acid (vitamin C) among the child population of the country reaches almost 95%, approximately 80% of children showed a deficiency of thiamine (vitamin B1), riboflavin (vitamin B2), pyridoxine (vitamin B6), niacin (vitamin B4 or PP) and folic acid (vitamin B9). Cognitive functions are the most complex and today not fully understood phenomenon. However, a whole complex of studies of the evaluation of individual cognitive processes, for example, such as reproduction, memory, clarity of mind, intensity of thought processes, ability to concentrate, training, problem solving, mobilization made it possible to trace a clear relationship between the cognitive functions of children and their provision with certain micronutrients .
Today, cognitive impairments are onefrom the most important problems of psychiatry and neurology. Such pathologies, unfortunately, are observed in about 20% of children and adolescents.
The prevalence of speech and function disorderslanguage, which include a disorder of writing and reading, ranges from 5% to 20%. Abnormalities of the autistic spectrum reach almost 17%. Lack of attention in conjunction with increased activity is observed in about 7% of children and adolescents. Also widespread are disorders of psychological development, emotional disturbances, syndromes of mental retardation and disorders of the behavioral sphere. However, the most common occurrence is the developmental disorders of learning skills, motor processes, mixed specific developmental disorders.
Cognitive disorders in children are most commonare found due to the transferred diseases characterized by the dysgenesis of the cerebral cortex, congenital metabolic disorders affecting the nervous system, degenerative diseases, lesions of the nervous system during fetal development.
To lesions of the nervous system in the perinatalperiod include: hypoxia of the brain, trauma received in the process of childbirth, intrauterine infection. Therefore, to this day, an important problem remains the diagnosis of the initial phases of disorders of cognitive functions in children. Its early results contribute to a more timely appointment of appropriate therapy and prevention of early disability of children. Today, the diagnosis of childhood pathologies in the cognitive field is possible only through a comprehensive clinical examination, clinical-psychopathological examination, psychometric, neuropsychological research methods.
Treatment of cognitive disorders
Disorders of the cognitive sphere in our timeare almost one of the most common neurological symptoms, since a significant part of the cerebral cortex has a direct connection with the provision of cognitive processes, so almost any disease that involves the brain will be accompanied by cognitive impairment.
Cognitive personality disorders combineviolations of the five main brain processes: gnosis, memory, speech, thinking and praxis. Often, the sixth process is added to these five processes - attention. Today, the question remains whether the attention has its own content or whether it is still a derivative. The problem of cognitive impairment, first of all, is the problem of an aging population.
Cognitive disorders are mild, moderate and severe.
Light disorders of cognitive processesare found only due to a thorough neuropsychological examination and, as a rule, do not affect everyday life, although sometimes they can give rise to subjective anxiety of the individual.
Moderate cognitive disorders advocatethe limits of the age norm, but so far they do not lead to limitations in everyday activities and affect only its complex forms. Individuals with moderate pathologies of the cognitive sphere, as a rule, retain their independence and autonomy.
Severe violations of the cognitivea significant negative impact on everyday life. Patients experience significant difficulties in daily activities, profession, activity, social sphere, and at later stages - in self-service. Dementia refers to severe cognitive pathologies.
The choice of a therapeutic strategy depends onthe causes of cognitive impairment and the severity of such disorders. If possible, the treatment should be carried out, which will be aimed at correcting the pathological processes that result from the body. In order to treat directly the disorders of cognitive processes, inhibitors of acetylcholinesterase of central action are used.
Also for the treatment of personality disorders applyand methods of psychotherapy. For example, in his book A. Beck and A. Freeman "Cognitive Psychotherapy of Personality Disorders" highlighted the problems of diagnosis and individual approach in the treatment of personality disorders using cognitive psychotherapy techniques, uncovered the impact of cognitive structures on the formation of personality disorders, views and attitudes that characterize each from such violations, reconstruction, transformation and reinterpretation of structures.
In the early stages of development of cognitive impairmentpsychotherapy of personality disorders is considered in many aspects "insight-therapy", which has in its arsenal introspective methods intended for personal transformation of the patient.
Cognitive therapy is aimed at helpingpatients in the study of their cognitive structures and the ability to modify their own behavior or thoughts. Studying the structures and patterns of cognitive processes and teaching adaptive reactions to negative thoughts and self-deprecating positions are ultimately the key goals of psychotherapy. It is necessary to strive for successive transformations, and not for the short-term result. The formulation of consistently more complicated tasks, successive small steps, evaluation of answers and responses from the position of desirable transformations, gradual adaptation to stress factors and anxiety, psychotherapeutic support allow the patient to make an attempt to change himself.
In the event of the appearance of cognitive impairment,most of them will progress tirelessly. That is why the main task in preventive measures of cognitive disorders is slowing down, suspension of the further course of the destructive process.
To prevent the progress of violationscognitive processes, you should regularly take medications (acetylcholinesterase inhibitors). Also it is necessary to try to support the broken processes. For this purpose, it is necessary to carry out various exercises aimed at training certain functions (for example, when memory disorders need to be taught poems). In addition, it is also necessary to avoid the influence of stressful situations, since during disturbances, violations of cognitive processes become even more pronounced.