Definition of organic personality disorder and the main criteria for making such a diagnosis. Etiological factors of occurrence and the main clinical signs of this disease. Modern approaches to the diagnosis and treatment of the disorder. Organic personality disorder is a disruption in the functioning of the brain due to morphological changes in its tissues, which manifests itself in a change in a person's personal and behavioral characteristics. That is, damage to brain cells causes the manifestation of symptoms at the mental level.
Description and development of organic personality disorder
The main and most important condition for the diagnosis of organic personality disorder is the presence in the history of any damage to the brain tissue of mechanical, infectious or other genesis. The more significant and wider the damage, the more severe the symptoms of organic personality disorder will be.
If the affected area is small, the rest of the cells can compensate for its function, and the person will not feel difficulties in cognitive processes, thinking, and speaking. But in the case of severe emotional overstrain, other stressful situations, such a disease can go into a phase of decompensation with the unfolding of the classic clinical picture of organic personality disorder.
The disease develops over the years, and some become accustomed to personality changes. At some stage, the disorder reaches social maladjustment, and it is much more difficult to help the patient in this case. Therefore, the appointment and reception of appropriate treatment will give a person valuable time for a quality life.
The mechanism of development of an organic disorder is hidden at the cellular level. Neurons damaged by disease or injury lose their ability to perform their functions in full, and signals are delayed. Naturally, other brain cells will try to take over part of the function of the injured area, but this is not always possible, especially if the affected area is quite large. First of all, thought processes, cognitive function, and intellect are affected. Accurate statistics cannot be confirmed, as organic personality disorder occurs as a co-morbid condition with many others. It is often not even diagnosed due to the severity of the underlying diagnosis.
Underlying Causes of Organic Personality Disorder
The variety of etiological factors creates some difficulties in the diagnosis and treatment of organic personality disorder. Among them, there are both mechanical injuries, infectious diseases, and oncological pathologies.
Most often, in practice, the following etiological factors are distinguished:
- Severe traumatic brain injury … Any kind of mechanical effect affects the state of the brain and can cause the development of various symptoms of organic genesis. The severity of the trauma must be significant for a persistent personality disorder to develop. In mild cases, neighboring cells can compensate for damage, and the person will not show changes in behavior, thinking, and other areas of activity.
- Infection … This should include viral diseases (including AIDS), bacterial diseases. Organic personality disorder is often caused by fungal neuroinfections. Their specificity is in the targeted damage of brain cells, as a result of which their function is lost. Depending on the localization of the pathological process, it can be encephalitis, encephalomeningitis and other diseases.
- Tumors … Unfortunately, the localization of the pathological process in the brain obliges even a benign differentiated tumor to be considered malignant. The proximity to the main centers of human life makes such a disease extremely dangerous. Therefore, one of the reasons for the development of organic personality disorder should be considered oncology. Even the smallest tumor disrupts the work of a local group of neurons and causes malfunctions that can affect the psyche and behavior of a person. This often happens even after sustained remission or radical surgery.
- Vascular diseases … The most common diseases at the moment - atherosclerosis, hypertension, diabetes mellitus - often choose the cerebral vessels as the target of their primary damage. Since they provide sensitive neuronal cells with oxygen and nutrients, a violation of cerebral blood flow will provoke an ischemic attack. In the long-term development of these diseases, chronic lack of oxygen by brain cells leads to disruption of their work and signal transmission. Consequently, this can manifest itself as mental symptoms in the form of an organic personality disorder.
- Alcoholism and drug addiction … The systematic use of any psychostimulants affects the work of the brain. Hallucinogens artificially irritate those areas of the cortex that are responsible for perception. Accordingly, over time, the cells cease to cope with the function put on them and a site of organic damage appears. This should include any psychoactive substances that can somehow affect the state of the brain and, with prolonged use, cause irreversible morphological changes.
- Autoimmune diseases … Some nosologies from this group are characterized by a specific effect on the nervous tissue. For example, in multiple sclerosis, the myelin sheath of neuroglial fibers is replaced by connective tissue. Point foci of such a process explain the name of this disease. The more nerve tissue is replaced with connective tissue, the greater the likelihood of developing an organic personality disorder.
- Seizures … The main reason for the most common disease in this group, epilepsy, is the presence of a permanent focus in which a nerve impulse constantly excites a certain part of the brain. This inevitably leads to disruption of the functioning of such zones and can manifest itself in changes in behavior and thinking. The longer a person has this disease, the more likely it is to develop an organic personality disorder.
Manifestations of organic personality disorder
The symptoms of this disease, regardless of the cause of its development, are quite similar. That is, all people with organic personality disorder have some common character traits that are not difficult to notice when talking. The depth of manifestation of the symptom already depends on the degree of brain damage.
The diagnosis of organic personality disorder can be made if a person has two or more of the following signs for more than six months:
- General behavior … First of all, a person changes his habits, emotions, needs. He approaches simple tasks differently, does not plan them and loses the ability to think several steps ahead. That is, strategic thinking is lost almost immediately. All these changes should be noted, taking into account the condition of the same person before the illness. For example, if he was frivolous, with a slightly euphoric mood and rarely thought ahead, then with an organic personality disorder, these symptoms can no longer be taken into account.
- Motivation … People with this disease gradually lose interest and motivation to perform difficult tasks, where it is necessary to overcome certain obstacles, difficulties in order to achieve a goal. From the outside, it looks like an apathetic unwillingness to change anything in your life. Along with this, the firmness of character is also lost. A person is not able to defend his own opinion and even form it for some reason. His type of thinking is greatly simplified.
- Instability … Such people are extremely emotional, but often their affect does not correspond to the situation around. That is, outbursts of aggression, unmotivated laughter, anger or bitterness are absolutely not associated with any factors in life. Often such emotions replace one another, and it is very difficult to convince a person of the groundlessness of such scenes. In addition, bouts of euphoria or persistent apathy are often noted.
- Failure to learn … It is very difficult for a person with organic personality disorder to study. If, for example, this is a child who was traumatized in childhood, then cognitive activity for him will be a significant difficulty. The acquisition of new skills and knowledge is a rather complex process that requires the activation of many mental processes and memorization mechanisms. With organic damage, cognitive activity is too complex a task for the brain.
- The viscosity of thinking … Cognitive function is one of the first to suffer from organic personality disorder. A person loses the ability to think quickly and effectively. Even the simplest tasks require maximum concentration and considerable effort from him. It takes some time to make an ordinary decision. The viscosity of thinking is found in almost all patients, which makes them similar to each other.
- Change in sexual behavior … This aspect, unlike the previous ones, can manifest itself in different ways. For some, this is an increase in libido, for others, on the contrary. It all depends on the specific type of person who suffers from an organic personality disorder. Various sexual deviations are common.
- Rave … A person suffering from an organic personality disorder can build their own "logical" chains, which will differ from the generally accepted ones. Over time, the patient becomes more suspicious, closely monitors the reaction of people, looking for a catch in their words, a hidden meaning. The paralogicality of judgments leads to the formation of delusional ideas, which can also be observed as part of an organic personality disorder.
How to deal with organic personality disorder
A variety of modern techniques allows you to find an approach to the treatment of almost any pathology of the psychiatric spectrum. The complexity of this disease is that it is inherently secondary and the underlying disease can complicate and limit the treatment of organic personality disorder. Therefore, a doctor should be involved in the selection of the optimal therapy. It is categorically impossible to treat such a pathology on your own!
Drug treatment
The arsenal of modern psychotropic drugs allows you to select the appropriate therapy for each symptom of organic personality disorder. That is, the approach is individual for a more specific effect. The choice of a specific drug is made by the doctor, taking into account the characteristics of each patient. The main groups of pharmacological psychotropic drugs:
- Anxiolytics … In some patients, viscous thinking and other cognitive impairments cause feelings of anxiety and anxiety. They cannot sit still and torment themselves. In this case, it would be advisable to prescribe drugs from the group of anxiolytics. These are fairly old, well-established means that have long been used in psychiatry to correct anxiety disorders. Most often, Diazepam, Phenazepam, Oxazepam are prescribed.
- Antidepressants … The condition of a person with cognitive impairment and emotional instability is extremely unstable. Depressive experiences are present in most patients, but only a few require the appointment of special pharmacological agents. Depression can significantly aggravate the course of the disease, so it is necessary to prevent it in a timely manner. Amitriptyline is mainly used for these purposes.
- Antipsychotics … This rather wide group of drugs is used in case of emotional instability, attacks of aggression, socially dangerous actions. Also, its appointment is advisable if there are delusional ideas, paranoid thoughts or psychomotor agitation in the clinical picture. Depending on the manifestation, one or another antipsychotic should be chosen. The most commonly used are Eglonil, Triftazin, Haloperidol.
- Nootropics … These drugs improve cerebral circulation, promote the flow of oxygen to the cells. Their appointment is necessary to improve or maintain cognitive functions at a level that ensures socialization and maintenance of a person's usual way of life. Representatives of nootropics are Phenibut, Aminalon.
Therapy of the underlying disease
Be sure to consider the presence of an etiological factor in the treatment of organic personality disorder. That is, an old head injury, tumor, infection, or other medical condition must be treated. If the severity of the underlying disease is not eliminated, the symptoms of organic personality disorder will be extremely difficult to stop. First of all, one should take into account the potentially life-threatening conditions that can be caused by the underlying disease. Treatment of organic personality disorder in this case will be completely inappropriate at this stage. Beginning therapy for mental changes should be after the elimination of the main manifestations of the disease, in their remission or compensation. For example, if a person has severe viral encephalitis, one should first pay attention to this pathology and only then, in the recovery period, start treating organic personality disorder. Often the symptoms of the latter can be eliminated under the therapy of the underlying disease. For example, vascular disease will cause much less manifestations if continued appropriate therapy is taken. It also reduces the likelihood of a personality disorder developing.
Psychotherapy
This direction in the treatment of organic personality disorder occupies an important role among the entire arsenal of methods. Its effectiveness can vary significantly from person to person, so the choice of psychotherapy is an individual decision.
First of all, you should figure out what psychotherapy is aimed at for organic personality disorder, and then compare the symptoms and decide on the appropriateness of such a method in a particular case:
- Depression … A conversation with an experienced psychotherapist will help to pull out all internal fears and prerequisites for a depressive state. With the help of psychotherapy, you can identify the presence of specific psychological problems on which a person is stuck, discuss them and solve them. Thus, through rationalization, it is possible to get rid of the depressive state.
- Intimate problems … Often, an increase or decrease in libido worries a person with an organic personality disorder. And due to shyness, apathy or autism, he cannot share with family and friends. With the help of psychotherapy, psychoanalysis in particular, it will be possible to identify such problems and find their psychological roots.
- Socialization … The ultimate goal of any psychotherapeutic assistance is to adapt the patient to an ordinary normal life, where he can function together with others, not differing or lagging behind. The task of the psychotherapist is to prevent problems that may arise during socialization and to develop such behavioral patterns that will effectively protect a person from feelings of inadequacy.
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Organic personality disorder is a fairly common disease that is currently incurable. That is, it is almost impossible to return a person to the state that was observed before the illness. The only goal of treatment is to stabilize the condition and eliminate the severity of manifestations.
