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Psycology » Psychiatry and psychotherapy » Organic mental disorders » Acute porphyria

The question of classifying types of porphyria complicated, and there is no need to go into detail (if you want the reader can get more information by contacting the appropriate training of medical literature). In Britain, the most common form of acute intermittent due to congenital inherited metabolic disorder transmitted by an autosomal dominant gene with incomplete penetrance. Acute porphyria is important for the psychiatrist, as observed in this disease picture may resemble hysteria, acute organic reaction or functional psychosis. It has been suggested (see: McAlpine, Hunter 1966), as if it is acute porphyria at the time was the cause of the madness of George III * (George III (1738-1820) King of England from 1760, and in 1811 due to his mental illness was appointed regent. Eds.), but despite the fact that adduced in support of this hypothesis, the arguments have demonstrated profound erudition and witty approach, such a conclusion is very doubtful. Acute intermittent porphyria occur at any age since puberty, but most often on the third ten. The clinical picture in different cases may vary considerably, but the most typical symptoms such as acute abdominal pain, pain in the limbs or back, nausea and vomiting, tachycardia, headaches, and severe constipation. Seizures occur in 20% of cases. Peripheral neuropathy may occur, affecting mainly the motor area. Often in the history of recorded laparotomy without detection of pathology. Psychopathological symptoms appear during an attack in 25-75% of cases, and sometimes dominate the clinical picture (Ackner et al. 1962). They include depression, anxiety and disturbed behavior. Emotions usually labile. May develop acute organic syndrome with impaired consciousness, and eventually coma. Often there are delusions and hallucinations. Attacks can be triggered by an acute infection, alcohol, certain medications and anesthesia, particularly barbiturates, contraception dichloralphenazone and methyldopa.

The basis for the diagnosis of porphyria is the detection of porphobilinogen and d-aminolevulinic acid in the urine. This disease does not apply to common use, and when porphyria occurs in psychiatric practice, it often goes undiagnosed. In those cases where there is a long history of intermittent somatic and psychological complaints, you should consider this diagnosis. Special Treatment Porphyria does not exist. The main goal is to prevent attacks by avoiding provotsiruyupschh influences. In most cases, the patient's condition improves, the attacks cease without sequelae. Few patients with disabling peripheral neuropathy due to constant or muscle wasting. Sometimes abnormal mental condition becomes chronic.


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