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Psycology » Organic mental disorders

Intracranial infections: tuberculous meningitis

Nowadays, tuberculous meningitis is rare and extremely difficult to diagnose. In practice, a psychiatrist from time to time meets this condition when it is manifested by apathy, irritability and personality change. Symptoms such as high fever, stiff neck, blurred consciousness, in many cases joined later, and therefore should again and again to carry out appropriate tests to detect them in a timely manner.

Intracranial infections: Myalgic encephalomyelitis benign

This is a rare disease that gives flash type epidemics, sometimes called Royal Free Disease due to the widely known outbreak observed in 1955 in a London hospital Royal Free Hospital. At various outbreaks to the typical manifestations include fatigue, headache, myalgia, paresis, psychiatric symptoms, the temperature may be slightly elevated or even normal. Mortality in such cases does not happen. At the beginning of the disease is sometimes inflamed throat and gastrointestinal symptoms observed. The severity of these symptoms contrasts with the absence of neurological signs, as well as the lack of data about the pathogen. After the first

Subdural hematoma

The psychiatrist should remember that subdural hematoma is not uncommon in falls associated with chronic alcoholism. Relevant symptoms in such cases can easily go unnoticed; sometimes they are misdiagnosed. Acute hematomas can cause coma or flickering consciousness and are often accompanied by hemiparesis and oculomotor disorders. As a rule, the psychiatrist is more inclined to pay attention to chronic symptoms for which the patient has a headache, makes vague physical complaints may experience flickering consciousness, but often there is little local neurological signs.

Of electrolyte and water metabolism

Various metabolic and electrolyte fluid in the body can cause psychiatric symptoms, usually (but not always) in the form of acute organic syndrome. Table. 11.5 lists the main psychological disorders (in brackets are some important physical symptoms and signs, information on other physical manifestations of various diseases can be found in the textbook on general medicine). Hypomagnesemia role is still unclear. Calcium metabolism disorders mentioned earlier in connection with damage to the parathyroid glands (see s.278), this aspect is of particular interest because, apparently, there is a close relationship between the concentration

Sleep disorders

To the psychiatrist may be asked to examine the patient, whose main problem is related to some or other sleep disorders or insomnia, which happens rarely with excessive sleepiness. Among patients who sleep poorly, many complain of fatigue, perceived during the day, and mood disorder. Although prolonged sleep deprivation causes a reduction of the productivity of intellectual activity and mood disorders, occasional lack of sleep in separate nights is not very important. Therefore symptoms was noted in the daytime in patients complaining of poor sleep, probably due to a greater extent cause CAUSED


In hyperthyroidism always some psychological symptoms, including anxiety, irritability and distractibility, which can be so severe that the overall picture resembles an anxiety disorder. In the past, acute organic psychiatric syndromes observed as part of a thyrotoxic crisis, but with modern methods of treatment such events are extremely rare. Few hyperthyroid patients diagnosed with schizophrenia or affective disorder, but it can be a coincidence. Differential diagnosis between thyrotoxicosis and anxiety disorder establish


When pituitary insufficiency are common psychiatric symptoms. After examining the data presented in the literature, and summarizing his observations, Kind (1958) concluded that 90% of patients with hypopituitarism present psychiatric symptoms, and half the heavy. The main symptoms include depression, apathy, lack of initiative, and drowsiness. Sometimes cognitive impairment in patients suffering from hypopituitarism so severe that it leads to an erroneous diagnosis of dementia. Another likely misdiagnosed minor depressive disorder. In the differential diagnosis with anorexia nervosa following


It would be logical to expect that psychiatric symptoms arising from corticosteroid therapy, will be identical to those observed in Cushing's syndrome, but in fact there are certain differences. If display is not particularly heavy, or more likely a light euphoria mania than depressive symptoms. In severe manifestations developing depressive disorder, as in Cushing's syndrome (see: Ling et al. 1981). Sometimes corticosteroid treatment causes acute organic syndrome in which there may be pronounced paranoid symptoms. The severity of the mental disorder is not dependent on dosing regimen. Patients

Cushing's syndrome (hypercortisolism)

As noted by Cushing in his original description, in this disease emotional disorder is a common phenomenon. Subsequently, Michael and Gibbons (1963) also found emotional distress in about half of the cases studied. On Cushing's disease usually pay attention because of somatic symptoms and signs, and any mental disorders almost always seen as a complication of the already known, previously identified cases. Somatic symptoms include moon face, buffalo hump, purple striae on the thighs and abdomen, hirsutism and hypertension. Women usually amenorrhea, and men with Cushing's syndrome often impotence

Syndrome Gilles de Tourette yes

This condition was first described by Itard (Itard) in 1825, followed by Gilles de la Tourette (Gilles de la Tourette) in 1895. The main clinical features of this disease starting at the age of 16 multiple motor tics in conjunction with voice ticks in which the patient involuntarily vocalizes type grunts, growls, etc. About half of these patients have coprolalia (uttering obscene words and phrases) rarer echolalia. In some cases, there are also stereotyped movements such as jumping and pritantsovyvanie. Tics usually precede other manifestations (Corbett et al. 1969). Related symptoms include hyperactivity
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