Organic personality disorder isA sustained impairment of brain function caused by illness or damage that causes a significant change in the behavior of the patient. This condition is marked by mental exhaustion and a decrease in mental functions. Disorders are found in childhood and are capable of reminiscent of themselves throughout life. The course of the disease depends on the age and the critical periods are considered dangerous: puberty and menopause. Under favorable conditions there can be a steady compensation of the individual with saving of work capacity, and if negative influences (organic disturbances, infectious diseases, emotional stresses) occur, the probability of decompensation with pronounced psychopathic manifestations is high.
In general, the disease has a chronic course, and inIn some cases progresses and leads to social maladjustment. Providing appropriate treatment, it is possible to improve the patient's condition. Often, patients avoid treatment without acknowledging the fact of the disease.
Causes of organic personality disorder
Organic disorders due to the huge number of traumatic factors are very common. The main causes of the disorders include:
- trauma (craniocerebral and damage to the frontal or temporal lobe of the head;
- Diseases of the brain (tumor, multiple sclerosis);
- Infectious brain damage;
- vascular diseases;
- encephalitis in combination with somatic disorders (parkinsonism);
- children's cerebral palsy;
- chronic manganese poisoning;
- temporal epilepsy;
- use of psychoactive substances (stimulants, alcohol, hallucinogens, steroids).
Patients suffering more than ten yearsEpilepsy, an organic personality disorder is formed. They hypothesize that there is a correlation between the degree of impairment and the frequency of seizures. Despite the fact that organic disorders have been studied since the end of the previous century, the features of development and the formation of symptoms of the disease have not been fully revealed. There is no reliable information about the influence of social and biological factors on this process. The pathogenetic link is based on brain lesions of exogenous origin, which lead to disturbances in inhibition and the correct correlation of the processes of excitation in the brain. At present, the most correct approach is the integrative approach in the detection of the pathogenesis of mental disorders.
Integrative approach involves the influence of the following factors: socio-psychological, genetic, organic.
Symptoms of organic personality disorder
Symptoms are characterized by characterological changes, manifested in the appearance of viscosity, bradyphrenia, torpidity, sharpening of premorbid features. Emotional state is noted either
, Or unproductive
, For the late stages is typical
And emotional lability. Threshold
In such patients is low, and an insignificant stimulus is capable of provoking an outbreak
. In general, the patient loses control ofImpulses and impulses. A person is not able to predict his own behavior relative to others, he is characterized by paranoia and suspicion. All his statements are stereotyped and are marked by characteristic flat, and also monotonous jokes.
At later stages, an organic disorder of personality is characterized by a dysmnesia that is able to progress and transform into a
Organic personality and behavior disorders
All organic disorders in behaviorArise after a head injury, infections (encephalitis) or as a result of a brain disease (multiple sclerosis). In human behavior, significant changes are noted. Often the emotional sphere is affected, and the ability of the person to control impulsiveness in behavior decreases. The attention of forensic psychiatrists to the organic disorder of a person in behavior is caused by the absence of control mechanisms, increased egocentricity, and the loss of social normal sensitivity.
Unexpectedly for all, formerly benevolentIndividuals begin to commit crimes that do not fit into their character. Over time, these people develop an organic cerebral state. Often this picture is observed in patients with anterior fracture of the brain.
Organic personality disorder is taken inAttention by the court as a mental illness. This disease is accepted as a mitigating circumstance and is the basis for referral to treatment. Often, problems occur in antisocial individuals with brain traumas, exacerbating their behavior. Such a patient because of the antisocial attitude towards situations and people, indifference to consequences and increased impulsiveness can be very difficult for psychiatric hospitals. The case also can be complicated
, Anger of the subject, which are associated with the fact of the disease.
In the 70s of the 20th century, researchersThe term "episodic loss of control syndrome" is proposed. It was suggested that there are individuals who do not suffer from brain damage, epilepsy,
, But which are aggressive due to the deepOrganic personality disorder. At the same time, aggression is the only symptom of this disorder. Most of the persons endowed with this diagnosis are men. They are marked by prolonged aggressive manifestations that go to childhood, with an unfavorable family background. The only evidence in favor of such a syndrome is EEG-anomalies, especially in the field of temples.
It was also suggested thatAbnormality of the functional nervous system leading to increased aggression. Physicians have suggested that severe forms of this condition are due to brain damage and they are able to remain in adulthood, as well as discover themselves in disorders associated with irritability, impulsiveness, lability, violence and explosiveness. According to statistics, the third part of this category in childhood was observed antisocial disorder, and in adulthood, most of them became criminals.
Diagnosis of an organic personality disorder
Diagnosis of the disease is based on the identification of characterological, emotional typical, as well as cognitive changes in the personality.
For the diagnosis of organic personality disorder the following methods are used: MRI, EEG, psychological methods (Rorschach test, MMPI, thematic apperceptive test).
Organic impairments of brain structures (trauma, disease or brain dysfunction), absence of memory and consciousness disturbances, manifestations of typical changes in the nature of behavior and speech are determined.
However, for the reliability of the diagnosisIt is important to observe the patient for at least half a year. During this period, the patient should show at least two signs in the organic violation of personality.
Diagnosis of an organic personality disorder is established in accordance with the requirements of ICD-10 in the presence of two of the following criteria:
- a significant decrease in the ability to carry out purposeful activities that require a long time and do not so quickly lead to success;
- altered emotional behavior, which is characterized by emotional lability, unjustified fun (euphoria, easily transferring to dysphoria with short-term attacks
And anger, in some cases manifestation of apathy);
- inclinations and needs that arise without taking into accountSocial conventions and consequences (antisocial orientation - theft, intimate ambitions, gluttony, non-compliance with personal hygiene rules);
- Paranoid ideas, as well as suspicion, excessive concern with an abstract theme, often religion;
- change of tempo in speech, hypergraphy, superinclusions (inclusion of collateral associations);
- changes in sexual behavior, including a decrease in sexual activity.
Organic personality disorder must be differentiated from dementia, in which personality disorders are often combined with memory impairments, with the exception of dementia in
. More precisely, the disease is diagnosed on the basis of neurological data, neuropsychological examination, CT and EEG.
Treatment of organic personality disorder
The effectiveness of treatment of organic disorderPersonality depends on an integrated approach. It is important in the treatment of a combination of medicamental and psychotherapeutic effects, which, when properly applied, enhance the impact of each other.
Drug therapy is based on the use of several types of drugs:
- anti-anxiety drugs (diazepam, phenazepam, elenium, oxazepam);
- Antidepressants (Clomipramine, Amitriptyline) are used in the development of the depressive state, as well as exacerbation of obsessive-compulsive disorder;
- Neuroleptics (Triftazin, Levomepromazin, Haloperidol, Eglonil) are used for aggressive behavior, as well as during an exacerbation of paranoid disorder and psychomotor agitation;
- nootropics (Phenibut, Nootropil, Aminolone);
- Lithium, hormones, anticonvulsants.
Often, medicines only affect the symptoms of the disease and after the drug is withdrawn the disease again progresses.
The main goal in the application of psychotherapeutic methods is to relax the patient's psychological state, help in overcoming intimate problems, depression,
, The assimilation of new patterns of behavior.
Assistance is provided both in the presence of physical,And mental problems in the form of a series of exercises or conversations. Psychotherapeutic effects using individual, group, family therapy will allow the patient to build up a literate relationship with family members, which will provide him with emotional support of relatives. Placement of a patient in a psychiatric hospital is not always necessary, but only in cases where it poses a danger to themselves or to others.
Prevention of organic disorders includes adequate obstetrics and rehabilitation in the postnatal period. Of great importance is proper upbringing in the family and at school.