Organic emotionally labile disorder

Affective personality disorders are understood as a group of mental diseases accompanied by disturbances of affect.
They are characterized by instability of mood, its decline (depression) or rise (manic state). At the same time, the intellectual and motor activity of the human brain changes. Affect is a vivid manifestation of feelings and emotions: facial expressions, gestures, anger, joy, etc. It can be adequate, that is, corresponding to the situation, or inadequate, in which behavior does not coincide with the thoughts expressed (an individual laughs when talking about the death of a loved one person).

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Organic personality disorder —changes in personality and behavior due to damage to brain tissue.

Any damaging effect on the nervous system causes changes in the mental state. But for a personality disorder to develop, the harmful effects must be long-lasting or leave behind irreversible changes in the form of neuronal death. atrophy of brain tissue, growth of neoplasms (cysts and brain tumors), impaired blood supply to the brain.

What it is

In ICD-10 (International Classification of Diseases, Tenth Revision), affective disorders are designated by codes F30-F39. There are several groups of them: chronic, endogenous, bipolar, recurrent, organic. They are quite common: every fourth person on Earth suffers from a mood disorder.

Organic disorder in ICD-10 is allocated separately under F06. It also includes:

• mild cognitive impairment;
• organic delusional (or schizophrenia-like) disorder;
• organic anxiety disorder;
• organic catatonic state.

This includes mental disorders associated with traumatic brain injury, the influence of hormones or toxic substances, as well as the negative manifestation of endocrine and other somatic diseases of the body.

An organic mood disorder is a disturbance of the emotional state that lasts for a long time and is combined with affect, mania, bipolar manifestations, and depression. It is caused by organic reasons: somatic diseases or taking medications.

There is no exact data on how common this pathology is. This is due to the reluctance of people suffering from it to seek medical help, since they believe that their condition is just a deterioration in their physical condition and “costs” of character. But even in those patients who come to the doctor, it is not easy to diagnose an affective mood disorder, so it is possible to detect it in a timely manner in only 30% of those who apply. And one more statistical conclusion: people of different ages, both adults and children, are susceptible to it, but people over 35 years of age and females are at greater risk.

Causes

Organic personality and behavior disorder develops after mechanical damage to the brain due to:

• Traumatic brain injuries.
• Chronic alcohol and drug poisoning.
• Prolonged oxygen starvation.
• Disturbances of blood flow to the brain. Strokes and cerebral infarctions.
• Epilepsy.
• Nervous system infections.
• Cerebral palsy.
• ADHD.
• Atrophy or neoplasm of brain tissue.
• Encephalopathies of any origin.

Organic personality disorder

Organic personality disorder is a persistent disorder of the brain, as a result of its disease, damage or dysfunction, causing a significant change in the patient’s behavior, decreased mental functions, and mental exhaustion. Disorders appear in childhood and can manifest themselves throughout life. The course of the disease depends on age; the most dangerous periods are critical periods, for example, puberty, menopause. Moreover, in favorable conditions, stable compensation of the individual can occur while maintaining the ability to work, and in the event of negative influences (infectious diseases, organic disorders, emotional stress), decompensation may occur, in which psychopathic manifestations become pronounced.

In general, the disease is chronic; in many cases, the disease progresses, leading to complete social maladaptation, but with appropriate treatment it is possible to improve the patient’s condition. Very often, patients avoid treatment and do not recognize the fact of the disease. Symptoms and diagnosis

To diagnose the disease, the following research methods are used: EEG, MRI, psychological methods (MMPI, Rorschach test, thematic apperception test). An organic disorder of brain structures of various etiologies (disease, injury or brain dysfunction), the absence of disturbances of consciousness and memory and the manifestation of typical changes in the nature of behavior and speech are revealed.

But for a clear diagnosis, long-term, at least six months, observation of the patient is necessary. During this period, the patient must show at least three signs of an organic personality disorder. The signs are:

• Inability to carry out activities, especially long-term ones, requiring concentration and volitional efforts. Especially if the receipt of the result of the activity is delayed or something does not work out;
• Severe emotional instability, inability to self-control, large fluctuations in the expression of emotions, euphoria or complete apathy, uncontrolled manifestations of aggression, severe irritability;
• Disinhibition of base instincts. Ignoring social norms, stealing. Inappropriate sexual behavior.
• Neglect of personal hygiene, sometimes gluttony.
• The emergence of paranoid concepts, unnatural suspicion. Obsession with one abstract idea, for example, religious.
• Categorical assessments of other people's behavior; Obvious changes in speech (hypergraphia, viscosity);
• Changes in sexual preferences, sometimes hypersexuality.

Although memory changes are usually not observed in the initial stages of the disease, as the disease progresses, memory disorders may appear, and this allows us to talk about dementia.

Causes

Due to the large number of damaging factors, ranging from birth trauma to radiation, organic disorders are very common.

The main causes of disorders are:

Traumatic head injuries and repeated injuries, especially damage to the temporal or frontal lobe;

• Infectious lesions of the brain;
• Brain diseases (multiple sclerosis, tumor);
• Vascular diseases (subarachnoid hematomas);
• Cerebral palsy;
• Encephalitis with subsequent somatic disorders (postencephalic parkinsonism);
• Chronic manganese poisoning;
• Use of psychoactive substances (alcohol, stimulants, steroids, hallucinogens);
• Temporal lobe epilepsy.

In patients suffering from epilepsy for more than ten years, an organic personality disorder develops, and it is assumed that there is a relationship between the frequency of seizures and the degree of the disorder.

Despite the fact that organic personality disorders have been studied since the end of the century before last, the features of the formation and development of symptoms remain unclear to this day. There is no convincing data on the influence of biological and social factors on this process. Brain lesions of exogenous origin are considered as the main pathogenetic link, leading to a violation of the correct balance between the processes of excitation and inhibition in the brain. In recent years, an integrative approach to identifying the pathogenesis of mental disorders has been considered the most accurate. This approach involves the influence of the following factors: genetic, organic, socio-psychological. However, no significant analysis has been carried out on this issue. Much attention has always been paid to the study of organic disorders caused by traumatic brain injury, while disorders resulting from neuroinfections, vascular diseases, and intoxications still remain poorly studied.

Treatment

For treatment of a disorder to be effective, it must be comprehensive. A combination of psychotherapeutic and medicinal effects is necessary, which, when used skillfully, enhance each other’s effects.

Drug therapy involves the use of several types of drugs:

• anti-anxiety
• antidepressants
• nootropics
• hormones, lithium, anticonvulsants.

However, often drugs affect only the symptoms of the disease and after discontinuation of the drug the disease progresses again.

The main purpose of using psychotherapeutic methods is to alleviate the psychological state of the patient, help in overcoming depression, sexual problems, obsessive fears, and in learning new patterns of behavior. Help is provided for both mental and physical problems, in the form of a conversation or a series of exercises. Psychotherapeutic influence involves the use of group, individual, family therapy, which will allow the patient to build correct relationships with family members, and also provide him with emotional support from relatives. In addition, psychotherapy will allow family members to learn the rules of behavior and communication with the patient. The main effect, if possible, should be aimed at the organic cause of the disease. And of course, we need to strive to minimize harmful effects (alcohol). Most often, only patients with a severe course of the disease come to the attention of a psychiatrist, but placing a patient in a psychiatric hospital is not always necessary, only if he is dangerous to others or to himself. Prevention of organic disorders begins with adequate obstetric care and rehabilitation in the postnatal period. Proper upbringing in school and family is of great importance.

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Symptoms

These signs should be observed for a long time (at least six months):

• Unstable mood , rapid change of emotions (from tears to laughter in an instant), attacks of melancholy-angry mood (dysphoria), a tendency to an increased stupid and blissful mood (euphoria) without external reasons for this.
• Loss or decrease in the ability to foresee the consequences of one's actions. Incontinence of drives and needs.
• Difficulty learning.
• Decreased memory and attention.
• Thinking in detail (getting stuck on little things).

Seasonal affective disorder

Seasonal affective disorder refers to endogenous depression; the development of the disorder is not associated with various causes or stress. Seasonal affective disorder develops at the same time of year, most often the disease worsens in the autumn-winter period. Researchers believe that a factor influencing the development of a mental disorder may be a genetic disorder or hereditary predisposition. There are a number of theories about the cause of the disorder:

• Genetic chromosomal abnormality, hereditary predisposition.
• It is assumed that a decrease in the production of neurotransmitters in the autumn-winter period leads to the development of seasonal affective disorder.
• Lack of sun, decreased day length, and disruption of molecular biochemical circadian rhythms affect the development of mental disorders.
• The disorder occurs when the body is predisposed to a disease under the influence of external factors.

Seasonal affective disorder has the following types of manifestations:

• The patient is drawn to sweets and starchy foods. The patient experiences weather sensitivity, drowsiness, and body weight increases due to increased appetite. This type of disorder is easy to treat, and the disease has a favorable prognosis.
• The patient is apathetic, has a decreased appetite, sleep disturbance - he sleeps little, and the reaction to external stimuli is reduced. This type of disorder has a longer period of exacerbation; depression can smoothly flow into the next period of depression. The disease requires adequate and timely treatment.

Symptoms of Seasonal Affective Disorder:

• The patient feels unwell in the morning, but in the evening he feels better.
• Activity decreases, tone and performance decrease, the patient quickly gets tired.
• In the autumn-winter period (less often in spring), the patient feels depressed, bad mood, and lack of positive emotions.
• Symptoms have been bothersome for more than two weeks.
• Memory is impaired, absent-mindedness appears.

Treatment

Three directions of treatment:

• Therapy of the underlying disease - organic damage to the nervous system.
• Restoration of not yet dead, preserved nerve cells.
• Psychotherapeutic work aimed at developing a critical attitude towards one’s condition, learning to control emotions and cognitive training.
• Psychological work with the patient’s loved ones.

Medication, physiotherapeutic, psychotherapeutic methods, biofeedback therapy, diet therapy, reflexology, exercise therapy and other methods are used.

Manifestation of affective syndrome

Pathology manifests itself in the form of negative emotional disorders, depressive states and mania. In some cases, accompanied by physiological disorders:

• difficulty breathing with a feeling of incomplete inspiration;
• heaviness in the chest;
• inhibition of movements and reactions;
• slowing down thought processes;
• loss of interest in things that were previously important to the patient.

Various types of depressive states manifested in pathology:

• manic-depressive psychoses;
• psychogenic depression;
• endogenous depressive states;
• depression of a somatic nature.

It is characterized by a sharp change, often occurring within one day. The period of attacks can last for several months and even years. Sleep disturbances are observed, appetite changes, and weight loss may occur.