Organic mental disorders. About “organic” mental disorders. F01.1х Multi-infarct dementia

The identification of this group is conditional. Divided into 2 categories:

· Endogenous-organic – epilepsy, atrophic diseases of the brain.

· Exogenous-organic – vascular diseases of the brain, head injury, tumors, brain infections.

Dementia– Sd or a chronic progressive brain disease in which memory, thinking, orientation, understanding, counting, speech, judgment, and learning ability are impaired. Consciousness is not changed, symptoms have been present for at least 6 months. Highlight the following types dementia:

· Primary– degenerative (presenile – 15%, senile – 45%), vascular (15-25%), mixed (11-20%).

· Secondary– hormonal, infectious, intoxicating.

Dementia grades:

Ø Mild dementia - reduced ability to memorize, errors in professional and social situations, not always noticeable to others. Violations in intellectual activity are detected only during targeted examination. Mild cognitive impairment noticeable on clinical examination. Patients cannot perform complex operations and cannot travel to an unfamiliar place. The ability for self-care and orientation in time and space are preserved.

Ø Average degree severity of dementia- cannot live without outside help. Memory is impaired - they cannot remember important events from their life, their sequence. They do not need help with eating or going to the toilet, but they have problems choosing clothes for the weather and getting dressed.

Ø Severe dementia– need constant supervision and care, have an idea only of individual facts of the present and past. Help is needed with self-care; verbal functions and psychomotor skills are lost.

Degenerative brain diseases(Alzheimer's and Pick's diseases) - typically occurring in presenile age, gradual development, progressive course without remissions, leading to complete dementia.

The substrate of the disease is the primary atrophic process.

Stages:

1. Initial– changes in intelligence, memory, attention without pronounced focal symptoms.

2. Severe dementia, focal symptoms – analytical, agnostic, atactic.

3. Terminal– deep mental decay, vegetative existence.

Alzheimer's disease was described in 1907. Its etiology has not been fully studied. A defect in chromosome 21 has been identified that is responsible for the development of this disease, which leads to the formation of amyloid in the posterior frontal regions of the dominant hemisphere.

A connection with acetylcholine transferase deficiency and alcohol abuse has also been identified. Family forms are described. Women suffer 2-3 times more often. The duration of the disease is 2-10 years. 2 variants of occurrence: presenile (before 65 years), senile (after 65 years). The following are distinguished: stages of the disease:

1. In the first stage, progressive memory impairment (according to Ribot's law), fixation amnesia, and growing amnestic disorientation are observed. Confabulations may appear as amnesia increases. There is no pathological animation, pseudo-activity, or lack of intelligence. These disorders can be hidden from others. They react very painfully to comments from loved ones, becoming irritable or depressed. Patients feel these changes and feel confused about this. “Alzheimer's amazement” appears - a peculiar change in facial expressions. There is a disorder of optical fixation (false recognitions), autoagnosia. In the end, signs of symptoms developing into focal ones appear, for example, disorientation with gross optical disturbances, apraxia, semantic aphasia.

2. At the second stage, obvious alexia, agraphia, apraxia, and aphasia appear. The loss of one or another function depends on the location of the atrophic focus. There is a violation of speech understanding; they cannot name objects (agnostic aphasia). Logoclonies are observed: at the beginning of the disease the patient repeats the first syllables of words, and at the end - the endings. Violent speech appears. Motor skills are destroyed. Disintegration of writing – micrographia, stereotypy, difficulties in writing individual numbers. Disintegration of reading (Alexia) and calculation (Acalculia).

A characteristic property is the rudimentary nature of manifestations. There is fragmentary nonsense (for example, damage, theft) without systematization. Delirium, anxiety, and depression may occur.

Aggression, psychomotor agitation, and unproductive activity appear. Neurological symptoms - increased muscle tone, epileptiform seizures, Parkinson's Sd.

3. In the third stage, severe dementia with complete collapse of the personality is observed.

Treatment Strategies: replacement therapy acetylcholinetransferase inhibitors (amiridine, domifezil), neuroprotective therapy (Cerebrolysin). When productive disorders appear, psychopharmacotherapy is carried out; for depression, 2nd generation antidepressants are prescribed. Conduct cognitive function training. NSAIDs and hormones are in development.

Pick's disease– the degenerative process is localized in the frontal areas. The genetic nature of the disease has been revealed, but may be involved in the pathogenesis increased content zinc in the soil. Features of the disease:

v Emotional-volitional disorders predominate. Patients are indifferent, passive, they have no internal motivation for activity. The moral and ethical level of the individual decreases, and intellectual deficiency is observed.

v Memory impairments are secondary, there are no confabulations.

v Euphoric states are frequent.

v Characteristic changes in speech are the “gramophone record” symptom, simplification of speech, stereotypical phrases (the phenomenon of “standing turns”, turning into mutism and echolalia), perseveration.

v At the second stage, apraxia, ataxia, aphasia, and alexia are observed.

v At the third stage, marasmus and vegetative coma occur.

Differential diagnosis of Alzheimer's disease and Pick's disease.

And I would like to start with one not very famous quote: « The term organic mental disorder is no longer used in DSM-IV because it implies that other "non-organic" mental disorders do not have a biological basis.» © 1994 American Psychiatric Association.

The love of some psychiatrists for the term “organic” mental disorder is so strong that it has already reached irrational strength. To begin with, the diagnosis is F06 (Other mental disorders due to damage and dysfunction of the brain or somatic illness) has turned into a real “garbage pit” into which all pathologies, to one degree or another associated with typical neurological or therapeutic diseases, are poured indiscriminately. This is such a local VSD: depression in this section, schizophrenia in this, anxiety in this, personal here, dementia there, drug addiction somewhere there, and for everything else there is F04-09.

The ideological moment is also very important here! While our teachers are competing “who can quote Gannushkin/Bleuler/Snezhnevsky/Jaspers/Smulevich, etc.” more, our colleagues are looking forward and are open to change and revision of the “old framework”. This is why the APA abandoned the term “organic” mental disorders more than twenty years ago, and why our poor students and residents are taught the NCMH classification with all “endogenous organic” mental disorders. The funny thing is that all those scientists quoted by our teachers were at the forefront of science at one time and with their work changed established views. Without this, we would still be stewing in the dark “bile” of Hippocrates, which is actually what is happening to us (metaphorically) now.

Moreover, everyone clearly sees the trend of neurological expansion into the psychiatric field of action. Starting from the complete conquest of epilepsy, ending with the fact that neurologists are no longer ashamed to treat depression, various mild psychotic inclusions, as well as obscure but beloved “astheno-neurotic” disorders. How they do this is a separate topic. Another thing is that, following epilepsy, neurologists have almost annexed neurocognitive disorders. Thus, one very respected and, probably, the most advanced dementia specialist in Russia is Professor O.S. Levin. (a neurologist, of course), at one large conference tried to explain to psychiatrists why neurologists deal with dementia: “Because dementia is an organic disease of the brain with psychiatric complaints.”

Here we can only recall the above conclusion that other “inorganic” mental disorders in this case do not have a biological basis. Indeed, why do we, psychiatrists, need “organic”? If there is Ribot's law, which we learned in psychopathology, why learn to read and understand MRI data, which can greatly help us in making a diagnosis? We are specialists in “psychics”!

There is nothing more to add here, because the reason why we should abandon the term “organic” mental disorders was written back in the DSM-IV in 1994. And this, for a second, is a nomenclature classification, and not some editorial in scientific journal with a large IF. And it’s not a matter of principle what to call this or that disorder; it won’t change much. The point is to understand the problem, and, therefore, to find ways to solve it.

It is also worth noting the pleasant changes in ICD 11, on which our practice will be based. IN new classification the subheading “Secondary mental or behavioral syndromes associated with disorders or diseases classified in other headings” will appear. However, these categories of “secondary” mental disorders will need to be used only in addition to the main diagnosis to ensure clinical attention to them. What's good about this? Firstly, there will finally be no “organic” mental disorders. Secondly, everyone will have to repeat the rules for making diagnoses not related to psychiatry in order to, at a minimum, understand what is happening to the patient. Thirdly, perhaps this innovation will at least to some extent affect the spread of such an absurd term as “organic” mental disorders.

/F00 - F09/ Organic, including symptomatic, mental disorders Introduction This section includes a group of mental disorders grouped together on the basis that they have a common, clear etiology of cerebral diseases, brain injuries or other damage leading to cerebral dysfunction. This dysfunction may be primary, as in some diseases, injuries, and strokes that affect the brain directly or preferentially; or secondary, as in systemic diseases and disorders that affect the brain only as one of many organs or systems of the body. Alcohol or drug use disorders, although logically expected to be included in this group, are classified in section F10 to F19 for the practical convenience of grouping all substance use disorders into one section. . Despite the wide range psychopathological manifestations conditions included in this section, the main features of these disorders form two main groups. On the one hand, there are syndromes where the most characteristic and constantly present are either damage to cognitive functions, such as memory, intelligence and learning, or disorders of awareness, such as disorders of consciousness and attention. On the other hand, there are syndromes where the most striking manifestation is disorders of perception (hallucinations), the content of thoughts (delusions), mood and emotions (depression, elation, anxiety) or general personality and behavior. Cognitive or sensory dysfunctions are minimal or difficult to detect. Last group disorders has less reason to be classified in this section than the first, because Many of the disorders included here are symptomatically similar to conditions classified in other sections (F20 - F29, F30 - F39, F40 - F49, F60 - F69) and can occur without the presence of gross cerebral pathology or dysfunction. However, there is growing evidence that many cerebral and systemic diseases are causally related to the occurrence of such syndromes and this sufficiently justifies their inclusion in this section from the point of view of a clinically oriented classification. In most cases, the disorders classified under this heading, at least in theory, can begin at any age except, presumably, early childhood. In fact, most of these disorders tend to begin in adulthood or later in life. Although some of these disorders (at the current state of our knowledge) appear to be irreversible, a number of others are transient or respond positively to currently available treatments. The term "organic" as used in the table of contents of this section does not mean that conditions in other sections of this classification are "inorganic" in the sense of having no cerebral substrate. In the present context, the term "organic" means that syndromes so classified can be explained by a self-diagnosed cerebral or systemic disease or disorder. The term "symptomatic" refers to those organic mental disorders in which the central concern is secondary to a systemic extracerebral disease or disorder. It follows from the above that in most cases, registering a diagnosis of any disorder in this section will require the use of 2 codes: one to characterize the psychopathological syndrome, and the second for the underlying disorder. The etiological code should be selected from other relevant chapters of the ICD-10 classification. It should be noted: In the adapted version of ICD-10, for registering mental disorders listed in this section, it is mandatory to use an additional sixth character to characterize an “organic”, “symptomatic” disease (meaning mental disorders in connection with somatic diseases, traditionally designated as “somatogenic disorders” ) underlying the diagnosable mental disorder: F0х.хх0 - due to brain injury; F0х.хх1 - due to vascular disease brain; F0х.хх2 - in connection with epilepsy; F0x.xx3 - due to a neoplasm (tumor) of the brain; F0х.хх4 - in connection with the human immunodeficiency virus (HIV infection); F0х.хх5 - in connection with neurosyphilis; F0х.хх6 - in connection with other viral and bacterial neuroinfections; F0х.хх7 - in connection with other diseases; F0х.хх8 - in connection with mixed diseases; F0х.хх9 - due to an unspecified disease. Dementia This part gives general description dementia to outline the minimum requirements for diagnosing any type of dementia. The following are criteria that can help determine how to diagnose a more specific type of dementia. Dementia is a syndrome caused by a brain disease, usually of a chronic or progressive nature, in which there are disorders of a number of higher cortical functions, including memory, thinking, orientation, comprehension, numeracy, learning, language and judgment. Consciousness is not changed. As a rule, there are disturbances in cognitive functions, which may be preceded by disturbances in emotional control, social behavior or motivation. This syndrome occurs in Alzheimer's disease, cerebrovascular disease, and other conditions that primarily or secondary affect the brain. When assessing the presence or absence of dementia, particular care must be taken to avoid misleading positive qualifications: Motivational or emotional factors, especially depression, in addition to motor retardation and general physical weakness, may be more responsible for poor performance than loss of intellectual ability. Dementia leads to a distinct decline in intellectual functioning and, most often, also to impairment of daily activities, such as washing, dressing, eating skills, personal hygiene, self-direction physiological functions. Such a decline may largely depend on the social and cultural environment in which the person lives. Changes in role functioning, such as decreased ability to continue or seek employment, should not be used as a criterion for dementia because of the significant cross-cultural differences that exist in determining what constitutes appropriate behavior in a given situation; often external influences affect the ability to obtain a job even within the same cultural environment. If symptoms of depression are present, but they do not meet the criteria for a depressive episode (F32.0x - F32.3x), their presence should be noted with a fifth character (the same applies to hallucinations and delusions): F0x .x0 without additional symptoms; F0х .x1 other symptoms, mostly delusional; F0х .x2 other symptoms, mainly hallucinatory; F0х .x3 other symptoms, mainly depressive; F0х .x4 other mixed symptoms. It should be noted: Isolation of additional psychotic symptoms in dementia as a fifth character refers to headings F00 - F03, while in the subheadings F03.3х and F03.4х the fifth character specifies what kind of psychotic disorder is observed in the patient, and in F02.8хх after the fifth character it is also necessary to use the sixth character, which will indicate the etiological nature of the observed mental disorder. Diagnostic instructions: The main diagnostic requirement is evidence of a decline in both memory and thinking to such an extent that it leads to disruption of the individual's daily life. Memory impairment in typical cases concerns the registration, storage and reproduction of new information. Previously acquired and familiar material may also be lost, especially in the later stages of the disease. Dementia is more than dysmnesia: there are also disturbances in thinking, reasoning and a reduction in the flow of thought. Processing of incoming information is impaired, which manifests itself in increasing difficulties in responding to several stimulating factors at the same time, such as when participating in a conversation in which several people are engaged, and when switching attention from one topic to another. If dementia is the only diagnosis, then it is necessary to establish the presence of clear consciousness. However, dual diagnosis, such as delirium with dementia, is quite common (F05.1x). The above symptoms and disorders must be present for at least 6 months for the clinical diagnosis to be convincing. Differential diagnosis: It is necessary to keep in mind: - depressive disorder(F30 - F39), which can exhibit many of the same characteristics as early dementia, especially memory impairment, slow thinking and lack of spontaneity; - delirium (F05.-); - mild or moderate mental retardation (F70 - F71); - states of subnormal cognitive activity associated with a serious impoverishment of the social environment and limited opportunity to study; - iatrogenic mental disorders caused by drug treatment (F06.-). Dementia may occur following or coexist with any of the organic mental disorders classified in this section, in particular delirium (see F05.1x). It should be noted: Headings F00.- (dementia due to Alzheimer's disease) and F02.- (dementia) tion for other diseases qualified in other sections) are marked with an asterisk ( * ). In accordance with chapter 3.1.3. Collection of instructions (“International statistical classification of diseases and related health problems. Tenth revision” (vol. 2, WHO, Geneva, 1995, p. 21) the main code in this system is the code of the main disease, it is marked with a “cross” ( + ); optional additional code related to the manifestation of the disease is marked with an asterisk ( * ). The code with an asterisk should never be used alone, but together with the code indicated by a cross. The use of a particular code (with an asterisk or cross) in statistical reporting is regulated in the instructions for drawing up the appropriate forms approved by the Ministry of Health of Russia.

/F00 * / Dementia due to Alzheimer's disease

(G30.- + )

Alzheimer's disease (AD) is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disease usually has a gradual onset and progresses slowly but steadily over several years. In time it can be 2 or 3 years, but sometimes much longer. Onset may be in middle age or even earlier (presenile-onset AD), but incidence is higher in late age and older (senile-onset AD). In cases with the onset of the disease before 65-70 years of age, there is a likelihood of a family history of similar forms of dementia, a faster rate of progression and characteristic features brain damage in the temporal and parietal region, including symptoms of dysphasia and dyspraxia. In cases with a later onset, there is a tendency towards slower development; the disease in these cases is characterized by a more general lesion of higher cortical functions. Patients with Down syndrome are at high risk of developing asthma. Characteristic changes in the brain are noted: a significant decrease in the population of neurons, especially in the hippocampus, substantia innominata, locus coeruleus; changes in the temporoparietal region and frontal cortex; the appearance of neurofibrillary tangles consisting of paired spiral filaments; neuritic (argentophilic) plaques, predominantly amyloid, showing a certain tendency towards progressive development (although there are plaques without amyloid); granulovascular bodies. Neurochemical changes were also detected, which included a significant decrease in the enzyme acetylcholine transferase, acetylcholine itself, and other neurotransmitters and neuromodulators. As has already been described, Clinical signs usually accompanied by brain damage. However, the progressive development of clinical and organic changes does not always go in parallel: there may be an undeniable presence of some symptoms with a minimal presence of others. However, the clinical signs of asthma are such that very often a presumptive diagnosis can be made only on the basis of clinical data. Currently, asthma is irreversible. Diagnostic guidelines: For a reliable diagnosis, the following signs must be present: a) The presence of dementia, as described above. b) Gradual onset with slowly increasing dementia. Although the time of onset of the disease is difficult to determine, detection of existing defects by others may occur suddenly. There may be some plateau in the development of the disease. c) Lack of clinical or special research, which could speak in favor of the fact that mental condition caused by other systemic or brain diseases leading to dementia (hypothyroidism, hypercalcemia, vitamin B-12 deficiency, nicotinamide deficiency, neurosyphilis, hydrocephalus normal pressure, subdural hematoma). d) Absence of sudden apoplectic onset or neurological symptoms associated with brain damage, such as hemiparesis, loss of sensitivity, changes in visual fields, loss of coordination, occurring early in the development of the disease (however, such symptoms may further develop against the background of dementia). In some cases, signs of AD and vascular dementia may be present. In such cases, double diagnosis (and coding) must take place. If vascular dementia precedes AD, then the diagnosis of AD cannot always be established on the basis of clinical data. Includes: - primary degenerative dementia of the Alzheimer's type. At differential diagnosis It is necessary to keep in mind: - depressive disorders (F30 - F39); - delirium (F05.-); - organic amnestic syndrome (F04.-); - other primary dementias, such as Pick, Creutzfeldt-Jakob, Huntington's diseases (F02.-); - secondary dementias associated with a number of somatic diseases, toxic conditions, etc. (F02.8.-); - mild, moderate and severe forms of mental retardation (F70 - F72). Dementia in asthma can be combined with vascular dementia (code F00.2x should be used), when cerebrovascular episodes (multi-infarct symptoms) can be superimposed on the clinical picture and history indicating asthma. Such episodes can cause a sudden worsening of dementia. According to autopsy data, a combination of both types of dementia is found in 10-15% of all cases of dementia.

F00.0x * Early onset Alzheimer's dementia

(G30.0 + )

Dementia in AD with onset before 65 years of age with a relatively rapidly progressive course and with multiple severe disorders of higher cortical functions. In most cases, aphasia, agraphia, alexia and apraxia appear in the relatively early stages of dementia. Diagnostic Guidelines: Keep in mind the picture of dementia given above, with onset before age 65 and rapid progression of symptoms. Family history data indicating the presence of asthma patients in the family may be an additional, but not mandatory, factor for establishing this diagnosis, just like information about the presence of Down's disease or lymphoidosis. Includes: - Alzheimer's disease, type 2; - primary degenerative dementia, Alzheimer's type, presenile onset; - presenile dementia of the Alzheimer's type. F00.1х * Late-onset Alzheimer's dementia (G30.1 + ) Dementia in AD, where there is a clinically established time of onset after 65 years of age (usually 70 years of age or later). There is a slow progression with memory impairment as the main feature of the disease. Diagnostic Guidelines: The description of dementia above should be followed with special attention to the presence or absence of symptoms differentiating it from early-onset dementia (F00.0). Includes: - Alzheimer's disease, type 1; - primary degenerative dementia, Alzheimer's type, senile onset; - senile dementia of the Alzheimer's type. F00.2 X * Dementia due to Alzheimer's disease, atypical or mixed type (G30.8 + ) This should include dementias that do not fit the description and diagnostic guidelines for F00.0 or F00.1, as well as mixed forms of AD and vascular dementia. Includes: - atypical dementia, Alzheimer's type. F00.9x * Dementia due to Alzheimer's disease, unspecified (G30.9 + ) /F01/ Vascular dementia Vascular (former arteriosclerotic) dementia, including multi-infarction, differs from dementia in Alzheimer's disease in the available information about the onset of the disease, clinical picture and subsequent course. In typical cases, transient ischemic episodes with short-term loss of consciousness, unstable paresis, and loss of vision are observed. Dementia can also occur after a series of acute cerebrovascular episodes, or, less commonly, after a single major hemorrhage. In such cases, memory impairment becomes obvious and mental activity. The onset (of dementia) may be sudden, following a single ischemic episode, or dementia may have a more gradual onset. Dementia usually results from cerebral infarction due to vascular disease, including hypertensive cerebrovascular disease. Heart attacks are usually small but have a cumulative effect. Diagnostic Guidelines: Diagnosis requires the presence of dementia as outlined above. Cognitive impairment is usually uneven and memory loss, intellectual decline, and focal neurological signs may be present. Criticism and judgment may be relatively intact. Acute onset or stepwise deterioration, as well as the presence of focal neurological signs and symptoms increase the likelihood of diagnosis. Confirmation of the diagnosis can in some cases be provided by computed axial tomography or ultimately by pathological findings. Associated symptoms include hypertension, carotid murmur, emotional lability with transient depressed mood, tearfulness or bursts of laughter, transient episodes of confusion or delirium, which may be precipitated by further infarctions. It is believed that personal characteristics relatively preserved. However, in some cases, personality changes may also be evident with the appearance of apathy or inhibition or an exacerbation of previous personality traits such as self-centeredness, paranoia or irritability. Includes: - arteriosclerotic dementia. Differential diagnosis: It is necessary to consider: - delirium (F05.xx); - other forms of dementia, and in particular Alzheimer's disease (F00.xx); - (affective) mood disorders (F30 - F39); - mild and moderate mental retardation (F70 - F71); - subdural hemorrhage, traumatic (S06.5), non-traumatic (I62.0)). Vascular dementia may be associated with Alzheimer's disease (code F00.2x) if vascular episodes occur in the context of a clinical picture and history suggestive of Alzheimer's disease.

F01.0х Vascular dementia with acute onset

Typically develops rapidly after a series of strokes or cerebrovascular thrombosis, embolism or hemorrhage. In rare cases, a single massive hemorrhage may be the cause.

F01.1х Multi-infarct dementia

The onset is more gradual, following several small ischemic episodes that create an accumulation of infarcts in the cerebral parenchyma. Includes: - predominantly cortical dementia.

F01.2x Subcortical vascular dementia

Includes cases characterized by a history of hypertension and ischemic destructive foci in the deep layers of the white matter of the cerebral hemispheres. The cerebral cortex is usually spared, and this contrasts with the clinical picture of Alzheimer's disease. F01.3x Mixed cortical and subcortical vascular dementia A mixed pattern of cortical and subcortical vascular dementia may be suspected based on clinical presentation, findings (including autopsy), or both.

F01.8x Other vascular dementia

F01.9х Vascular dementia, unspecified

/F02 * / Dementia in other diseases,

classified in other sections

Cases of dementia due or suspected to be due to causes other than Alzheimer's disease or cerebrovascular disease. Onset can occur at any age, but rarely at a later age. Diagnostic guidelines: Presence of dementia as outlined above; the presence of features characteristic of one of the specific syndromes outlined in the following categories.

F02.0x * Dementia in Pick's disease

(G31.0 + )

The progressive course of dementia begins in middle age (usually between 50 and 60 years), with slowly increasing character changes and social decline, followed by intellectual impairment, memory loss, speech function with apathy, euphoria and (sometimes) extrapyramidal phenomena. The pathological picture of the disease is characterized by selective atrophy of the frontal and temporal lobes, but without the appearance of neuritic (argentophilic) plaques and neurofibrillary tangles in excess quantities compared to normal aging. At early start there is a tendency towards a more malignant course. Social and behavioral manifestations often precede overt memory impairment. Diagnostic guidelines: For a reliable diagnosis, the following signs are necessary: ​​a) progressive dementia; b) prevalence of frontal symptoms with euphoria, emotional pallor, rough social behavior, disinhibition and either apathy or restlessness; c) such behavior usually precedes clear memory impairment. Frontal symptoms are more severe than temporal and parietal symptoms, in contrast to Alzheimer's disease. Differential diagnosis: It is necessary to keep in mind: - dementia due to Alzheimer's disease (F00.xx); - vascular dementia (F01.xx); - dementia secondary to other diseases, such as neurosyphilis (F02.8x5); - dementia with normal intracranial pressure (characterized by severe psychomotor retardation, disturbance of gait and sphincter function (G91.2); - other neurological and metabolic disorders.

F02.1x * Dementia in Creutzfeldt-Jakob disease

(A81.0 + )

The disease is characterized by progressive dementia with extensive neurological symptoms caused by specific pathological changes (subacute spongiform encephalopathy), which are presumably caused by a genetic factor. Onset is usually in middle or late age, and in typical cases in the fifth decade of life, but can occur at any age. The course is subacute and leads to death after 1-2 years. Diagnostic Guidelines: Creutzfeldt-Jakob disease should be suspected in all cases of dementia that progress rapidly over months or 1-2 years and are accompanied by multiple neurological symptoms. In some cases, as in the so-called amyotrophic forms, neurological signs may precede the onset of dementia. Typically there is progressive spastic paralysis of the limbs, with associated extrapyramidal signs, tremor, rigidity and characteristic movements. In other cases, there may be ataxia, decreased vision, or muscle fibrillation and upper motor neuron atrophy. A triad consisting of the following signs is considered very typical for this disease: - rapidly progressing, devastating dementia; - pyramidal and extrapyramidal disorders with myoclonus; - characteristic triphasic EEG. Differential diagnosis: It is necessary to consider: - Alzheimer's disease (F00.-) or Pick's disease (F02.0x); - Parkinson's disease (F02.3x); - postencephalitic parkinsonism (G21.3). Fast flow and early onset motor disorders may speak in favor of Creutzfeldt-Jakob disease.

F02.2x * Dementia in Huntington's disease

(G10 + ) Dementia occurs as a result of extensive degeneration of the brain. The disease is transmitted by a single autosomal dominant gene. In typical cases, symptoms appear in the 3rd or 4th decade of life. No gender differences are noted. In some cases, early symptoms include depression, anxiety, or overt paranoid symptoms with personality changes. Progression is slow, usually leading to death within 10-15 years. Diagnostic guidelines: Combination of choreiform movements, dementia and hereditary history of Huntington's disease in high degree suggest this diagnosis, although sporadic cases can certainly occur. Early manifestations of the disease include involuntary choreiform movements, especially in the face, arms, shoulders or gait. They usually precede dementia and are rarely absent in advanced dementia. Other motor phenomena may be more prevalent when the disease is present at an unusually young age (eg, striatal rigidity) or later in life (eg, intention tremor). Dementia is characterized by a predominant involvement of the functions of the frontal lobe in the process at an early stage of the disease, with relatively intact memory until later. Includes: - dementia due to Huntington's chorea. Differential diagnosis: It is necessary to consider: - other cases with choreiform movements; - Alzheimer's, Pick, Creutzfeldt-Jakob diseases (F00.-; F02.0х; F02.1х).

F02.3х * Dementia in Parkinson's disease

(G20 + ) Dementia develops against the background of established Parkinson's disease (especially in its severe forms). No characteristic clinical symptoms were identified. Dementia that develops during Parkinson's disease may differ from dementia in Alzheimer's disease or vascular dementia. However, it is possible that dementia in these cases may be combined with Parkinson's disease. This justifies the classification of such cases of Parkinson's disease for scientific purposes until these issues are resolved. Diagnostic Guidelines: Dementia that develops in a person with advanced, most often severe, Parkinson's disease. Differential diagnosis: Consider: - other secondary dementias (F02.8-); - multi-infarct dementia (F01.1x), due to hypertension or diabetic vascular disease; - brain tumors (C70 - C72); - hydrocephalus with normal intracranial pressure (G91.2). Includes: - dementia with shaking palsy; - dementia due to parkinsonism. F02.4x * Dementia due to human immunodeficiency virus (HIV) disease (B22.0 + ) Disorders characterized by cognitive deficits that meet the clinical diagnostic criteria for dementia, in the absence of an underlying disease or condition other than HIV infection that could explain the clinical findings. Dementia due to HIV infection is usually characterized by complaints of forgetfulness, slowness, difficulty concentrating, and difficulty solving problems and reading. Apathy, decreased spontaneous activity, and social withdrawal are common. In some cases, the disease may manifest itself in atypical affective disorders, psychosis or seizures. Physical examination reveals tremor, rapid repetitive movement disorder, incoordination, ataxia, hypertension, generalized hyperreflexia, frontal disinhibition, and oculomotor dysfunction. An HIV-related disorder can occur in children and is characterized by developmental delay, hypertension, microcephaly, and basal ganglia calcification. Unlike adults, neurological symptoms can occur in the absence of infections caused by opportunistic microorganisms and neoplasms. Dementia due to HIV infection usually, but not necessarily, progresses rapidly (over weeks and months) to global dementia, mutism, and death. Includes: - AIDS dementia complex; - HIV encephalopathy or subacute encephalitis. /F02.8х * / Dementia in other specified diseases classified elsewhere sections Dementia can occur as a manifestation or consequence of various cerebral and somatic conditions. Includes: - Guam parkinsonism-dementia complex (Should also be coded here. This is a rapidly progressing dementia with the addition of extrapyramidal dysfunction and in some cases amyotrophic lateral sclerosis. This disease was first described on the island of Guam, where it occurs quite often in the indigenous population and is 2 times more more common in men than women. The disease is also known to occur in Papua New Guinea and Japan.)

F02.8x0 * Dementia

(S00.- + - S09.- + )

F02.8x2 * Dementia due to epilepsy (G40.-+)

F02.8x3 * Dementia (C70.- + - C72.- + ,

C79.3 + , D32.- + , D33.- + , D43.- + )

F02.8x5 * Dementia due to neurosyphilis

(A50.- + - A53.- + )

F02.8x6 * Dementia due to other viral and bacterial neuroinfections (A00.- + -B99.- + ) Includes: - dementia due to acute infectious encephalitis; - dementia caused by meningo-encephalitis due to lupus erythematosus.

F02.8x7 * Dementia due to other diseases

Includes: - dementia due to: - carbon monoxide poisoning (T58+); - cerebral lipidosis (E75.- +); - hepatolenticular degeneration (Wilson's disease) (E83.0 +); - hypercalcemia (E83.5 +); - hypothyroidism, including acquired (E00.- + - E07.- +); - intoxications (T36.- + - T65.- +); - multiple sclerosis (G35 +); - nicotinic acid deficiency (pellagra) (E52+); - polyarthritis nodosa (M30.0 +); - trypanosomiasis (African B56.- +, American B57.- +); - deficiency of vitamin B 12 (E53.8 +).

F02.8x8 * Dementia

F02.8x9 * Dementia

/F03/ Dementia, unspecified

This category should be used when the general criteria meet the diagnosis of dementia, but the specific type cannot be specified (F00.0x - F02.8xx). Includes: - presenile dementia NOS; - senile dementia NOS; - presenile psychosis NOS; - senile psychosis NOS; - senile dementia of depressive or paranoid type; - primary degenerative dementia NOS. Excluded: - involutional paranoid (F22.81); - late-onset Alzheimer's disease (F00.1x *); - senile dementia with delirium or confusion (F05.1х); - old age NOS (R54).

F03.1x Presenile dementia, unspecified

It should be noted: This subsection includes dementia in persons aged 45–64 years, when difficulties arise in determining the nature of this disease. Included: - presenile dementia NOS.

F03.2x Senile dementia, unspecified

It should be noted: This subsection includes dementia in persons aged 65 years and older when it is difficult to determine the nature of the disease. Included: - senile dementia of depressive type; - senile dementia of paranoid type.

F03.3x Presenile psychosis, unspecified

It should be noted: This subsection includes psychosis in persons aged 45–64 years, when difficulties arise in determining the nature of this disease. Included: - presenile psychosis NOS.

F03.4x Senile psychosis, unspecified

It should be noted: This subsection includes psychosis in persons aged 65 years and older when it is difficult to determine the nature of the disorder. Included: - senile psychosis NOS.

/F04/ Organic amnesic syndrome,

not caused by alcohol or

others psychoactive substances

Syndrome of severe memory impairment for recent and distant events. While direct reproduction is preserved, the ability to assimilate new material is reduced, resulting in anterograde amnesia and disorientation in time. Retrograde amnesia of varying intensity is also present, but its range may decrease over time if the underlying disease or pathological process tends to recover. Confabulations can be pronounced, but are not a mandatory feature. Perception and other cognitive functions, including intellectual ones, are usually preserved and provide the background against which memory impairment becomes especially obvious. The prognosis depends on the course of the underlying disease (usually affecting the hypothalamic-diencephalic system or the hippocampal region). In principle, a complete recovery is possible. Diagnostic guidelines: For a reliable diagnosis, the following symptoms must be present: a) the presence of memory impairment for recent events (decreased ability to assimilate new material); anterograde and retrograde amnesia, decreased ability to reproduce past events in reverse order their occurrence; b) history or objective data indicating the presence of stroke or brain disease (especially involving bilateral diencephalic and medial temporal structures); c) absence of a defect in direct reproduction (tested, for example, by memorizing numbers), disturbances of attention and consciousness, and global intellectual impairment. Confabulation, lack of criticism, emotional changes (apathy, lack of initiative) are an additional, but not necessary in all cases, factor for establishing a diagnosis. Differential diagnosis: This disorder differs from other organic syndromes where memory impairment is the leading cause. clinical picture(eg dementia or delirium). From dissociative amnesia (F44.0), from impaired memory functions in depressive disorders (F30 - F39) and from malingering, where the main complaints relate to memory loss (Z76.5). Korsakoff syndrome caused by alcohol or drugs should not be coded in this section, but in the corresponding one (F1x.6x). Includes: - conditions with full-blown amnestic disorders without dementia; - Korsakoff syndrome (non-alcoholic); - Korsakov psychosis (non-alcoholic); - pronounced amnestic syndrome; - moderate amnestic syndrome. Excluded: - mild amnestic disorders without signs of dementia (F06.7-); - amnesia NOS (R41.3); - anterograde amnesia (R41.1); - dissociative amnesia (F44.0); - retrograde amnesia (R41.2); - Korsakoff syndrome, alcoholic or unspecified (F10.6); - Korsakoff syndrome caused by the use of other psychoactive substances (F11 - F19 with a common fourth character.6). F04.0 Organic amnestic syndrome due to traumatic brain injury F04.1 Organic amnesic syndrome F04.2 Organic amnestic syndrome due to epilepsy F04.3 Organic amnestic syndrome due F04.4 Organic amnesic syndrome F04.5 Organic amnestic syndrome due to neurosyphilis F04.6 Organic amnestic syndrome F04.7 Organic amnesic syndrome due to other diseases F04.8 Organic amnestic syndrome due to mixed diseases F04.9 Organic amnestic syndrome due to unspecified disease /F05/ Delirium not caused by alcohol or other psychoactive substances An etiologically nonspecific syndrome characterized by a combined disorder of consciousness and attention, perception, thinking, memory, psychomotor behavior, emotions and sleep-wake rhythm. It can occur at any age, but is more common after 60 years of age. The delirious state is transient and fluctuating in intensity. Recovery usually occurs within 4 weeks or less. However, fluctuating delirium lasting up to 6 months is not uncommon, especially if it occurs within chronic disease liver, carcinoma or subacute bacterial endocarditis. The distinctions sometimes made between acute and subacute delirium are of slight clinical significance and such conditions should be considered as a single syndrome of varying duration and severity (from mild to very severe). A delirious state can occur in the context of dementia, or develop into dementia. This section should not be used to refer to delirium due to psychoactive substances that are listed in F10 to F19. Delirious states due to the use of drugs should be classified under this heading (such as acute confusion in elderly patients due to the use of antidepressants). In this case, the drug used must also be identified by 1 MH code Class XIX, ICD-10). Diagnostic Guidelines: For a definitive diagnosis, lungs or severe symptoms from each of the following groups: a) altered consciousness and attention (from stupor to coma; reduced ability to direct, focus, maintain and switch attention); b) global cognitive disorder (perceptual distortions, illusions and hallucinations, mainly visual; disturbances in abstract thinking and understanding with or without transient delusions, but usually with some degree of incoherence; disturbance of immediate reproduction and memory for recent events with relative preservation of memory for distant events ; disorientation in time, and more severe cases in place and self); V) psychomotor disorders(hypo- or hyperactivity and unpredictability of transition from one state to another; increase in time; increased or decreased flow of speech; reactions of horror); d) sleep-wake rhythm disorders (insomnia, and in severe cases - total loss of sleep or inversion of the sleep-wake rhythm: drowsiness during the day, worsening symptoms at night; restless dreams or nightmares, which can continue as hallucinations upon awakening); d) emotional disorders, such as depression, anxiety or fears. Irritability, euphoria, apathy or bewilderment and confusion. The onset is usually rapid, fluctuating throughout the day, and the total duration is up to 6 months. The clinical picture described above is so characteristic that a relatively reliable diagnosis of delirium can be made even if its cause is not established. In addition to anamnestic indications of cerebral or somatic pathology underlying delirium, evidence of cerebral dysfunction is also required (eg, abnormal EEG, usually but not always showing slowing background activity), if the diagnosis is in doubt. Differential diagnosis: Delirium must be distinguished from other organic syndromes, especially dementia (F00 - F03), from acute and transient psychotic disorders (F23.-) and from acute conditions in schizophrenia (F20.-) or from (affective) mood disorders (F30 - F39), in which features of confusion may be present. Delirium caused by alcohol and other psychoactive substances should be classified in the appropriate section (F1x.4xx). Includes: - acute and subacute state of confusion (non-alcoholic); - acute and subacute brain syndrome; - acute and subacute psychoorganic syndrome; - acute and subacute infectious psychosis; - acute exogenous type of reaction; - acute and subacute organic reaction. Excludes: - delirium tremens, alcoholic or unspecified (F10.40 - F10.49).

/F05.0/ Delirium not associated with dementia, as described

This code should be used for delirium not associated with pre-existing dementia. F05.00 Delirium not associated with dementia due to traumatic brain injury F05.01 Delirium not associated with dementia due to vascular disease of the brain F05.02 Delirium not associated with dementia due to epilepsy F05.03 Delirium not associated with dementia due to a neoplasm (tumor) of the brain F05.04 Delirium not associated with dementia due F05.05 Delirium not associated with dementia due to neurosyphilis F05.06 Delirium not associated with dementia due F05.07 Delirium not associated with dementia due to other diseases F05.08 Delirium not associated with dementia due to mixed diseases F05.09 Delirium not associated with dementia due to unspecified disease /F05.1/ Delirium due to dementia This code should be used for conditions that meet the above criteria but develop during the course of dementia (F00 - F03). It should be noted: If you have dementia, you can use dual codes. F05.10 Delirium associated with dementia due to traumatic brain injury F05.11 Delirium due to dementia due to vascular disease of the brain F05.12 Delirium due to dementia due to epilepsy F05.13 Delirium due to dementia due to a neoplasm (tumor) of the brain F05.14 Delirium due to dementia due to human immunodeficiency virus (HIV infection) F05.15 Delirium due to dementia due to neurosyphilis F05.16 Delirium due to dementia in connection with other viral and bacterial neuroinfections F05.17 Delirium due to dementia due to other diseases F05.18 Delirium due to dementia due to mixed diseases F05.19 Delirium due to dementia due to an unspecified illness/F05.8/ Other delirium Includes: - delirium of mixed etiology; - subacute confusion or delirium. It should be noted: This subheading should include cases where the presence or absence of dementia cannot be determined. F05.80 Other delirium due to brain injury F05.81 Other delirium due to vascular disease of the brain F05.82 Other delirium due to epilepsy F05.83 Other delirium due to a neoplasm (tumor) of the brain F05.84 Other delirium due to human immunodeficiency virus (HIV infection) F05.85 Other delirium due to neurosyphilis F05.86 Other delirium in connection with other viral and bacterial neuroinfections F05.87 Other delirium in connection with other diseases F05.88 Other delirium due to mixed diseases F05.89 Other delirium due to an unspecified illness/F05.9/ Delirium, unspecified It should be noted: This subcategory includes cases that do not fully meet all the criteria for delirium described in ICD-10 (F05.-).

F05.90 Unspecified delirium

due to brain injury

F05.91 Unspecified delirium

/F06.0/ Organic hallucinosis

This is a disorder of persistent or recurrent hallucinations, usually visual or auditory, that appear during clear consciousness and may or may not be recognized as such by the patient. A delusional interpretation of hallucinations may arise, but usually criticism is retained. Diagnostic guidelines: In addition to general criteria given in the introduction to F06, the presence of persistent or recurrent hallucinations of any kind is required; absence of darkened consciousness; absence of pronounced intellectual decline; absence of a dominant mood disorder; absence of dominant delusional disorders. Includes: - dermatozoal delirium; - organic hallucinatory state (non-alcoholic). Excluded: - alcoholic hallucinosis (F10.52); - schizophrenia (F20.-).

F06.00 Hallucinosis due to traumatic brain injury

F06.01 Hallucinosis due to

with cerebrovascular disease

F06.02 Hallucinosis due to epilepsy

F06.03 Hallucinosis due to

with a neoplasm (tumor) of the brain

F06.04 Hallucinosis due to

with human immunodeficiency virus (HIV infection)

F06.05 Hallucinosis due to neurosyphilis

F06.06 Hallucinosis due to

with other viral and bacterial neuroinfections

F06.07 Hallucinosis due to other diseases

F06.08 Hallucinosis due to mixed diseases

F06.09 Hallucinosis due to unspecified disease

/F06.1/ Organic catatonic state

A disorder with decreased (stupor) or increased (excitement) psychomotor activity, accompanied by catatonic symptoms. Polar psychomotor disorders may intermittently occur. It is not yet known whether the full range of catatonic disorders described in schizophrenia can also occur in organic conditions. Also, it has not yet been established whether an organic catatonic state can occur with clear consciousness, or whether it is always a manifestation of delirium followed by partial or total amnesia. Therefore, care must be taken in establishing this diagnosis and in clearly distinguishing the condition from delirium. It is believed that encephalitis and poisoning carbon monoxide This syndrome is more likely to cause this syndrome than other organic causes. Diagnostic guidelines: The general criteria suggestive of an organic etiology outlined in the introduction to F06 must be met. In addition, the following must be present: a) either stupor (decreased or complete absence spontaneous movements, with partial or complete mutism, negativism and freezing); b) either agitation (general hypermobility with or without a tendency to aggression); c) or both states (quickly, unexpectedly alternating states of hypo- and hyperactivity). Other catatonic phenomena that increase the reliability of the diagnosis include stereotypies, waxy flexibility, and impulsive acts. Excluded: - catatonic schizophrenia (F20.2-); - dissociative stupor (F44.2); - stupor NOS (R40.1). F06.10 Catatonic state due to traumatic brain injury F06.11 Catatonic state due to cerebrovascular disease F06.12 Catatonic state due to epilepsy F06.13 Catatonic state due to with a neoplasm (tumor) of the brain F06.14 Catatonic state due to with human immunodeficiency virus (HIV infection) F06.15 Catatonic state due to neurosyphilis F06.16 Catatonic state due to with other viral and bacterial neuroinfections F06.17 Catatonic state due to other diseases F06.18 Catatonic state due to mixed diseases F06.19 Catatonic state due to unspecified disease /F06.2/ Organic delusional (schizophrenia-like) disorder A disorder in which persistent or recurrent delusions dominate the clinical picture. Delusions may be accompanied by hallucinations, but are not tied to their content. May also be present clinical symptoms symptoms similar to schizophrenia, such as fanciful delusions, hallucinations or thought disorders. Diagnostic Guidelines: The general criteria suggesting an organic etiology outlined in the introduction to F06 must be met. In addition, delusions (of persecution, jealousy, influence, illness or death of the patient or another person) must be present. Hallucinations, thought disturbances, or isolated catatonic phenomena may be present. Consciousness and memory should not be upset. A diagnosis of organic delusional disorder should not be made if organic cause is nonspecific or supported by limited evidence, such as enlarged cerebral ventricles (visually noted on computed axial tomography) or "soft" neurological signs. Includes: - paranoid or hallucinatory-paranoid organic states. Excluded: - acute and transient psychotic disorders (F23.-); - drug-induced psychotic disorders (F1x.5-); - chronic delusional disorder (F22.-); - schizophrenia (F20.-). F06.20 Delusional (schizophrenia-like) disorder due to traumatic brain injury F06.21 Delusional (schizophrenia-like) disorder due to cerebrovascular disease F06.22 Delusional (schizophrenia-like) disorder due to epilepsy Includes: - schizophrenia-like psychosis in epilepsy. F06.23 Delusional (schizophrenia-like) disorder due to a neoplasm (tumor) of the brain F06.24 Delusional (schizophrenia-like) disorder due to human immunodeficiency virus (HIV infection) F06.25 Delusional (schizophrenia-like) disorder due to neurosyphilis F06.26 Delusional (schizophrenia-like) disorder in connection with other viral and bacterial neuroinfections F06.27 Delusional (schizophrenia-like) disorder due to other diseases F06.28 Delusional (schizophrenia-like) disorder due to mixed illnesses F06.29 Delusional (schizophrenia-like) disorder due to unspecified illness /F06.3/ Organic mood disorders (affective) Disorders characterized by changes in mood, usually accompanied by changes in the level of general activity. The only criterion for inclusion of such disorders in this section is that they are presumably directly attributable to a cerebral or physical disorder, the presence of which must be demonstrated by an independent method (for example, by adequate somatic and laboratory research) or on the basis of adequate anamnestic information. Affective disorders should appear following the discovery of the suspected organic factor. Such mood changes should not be regarded as the patient’s emotional response to news of illness or as symptoms of a concomitant (affective disorder) brain disease. Post-infectious depression (following influenza) is a common example and should be coded here. Persistent mild euphoria, not reaching the level of hypomania (which is sometimes observed, for example, with steroid therapy or antidepressant treatment), should not be recorded in this section, but under the heading F06.8-. Diagnostic guidelines: In addition to the general criteria suggesting an organic etiology outlined in the introduction to F06, the condition must meet the diagnostic requirements specified in F30-F33. It should be noted: To be sure clinical disorder it is necessary to use 5-digit codes in which the specified disorders are divided into disorders of the psychotic and non-psychotic level, unipolar (depressive or manic) and bipolar. /F06.30/ psychotic manic disorder organic nature; /F06.31/ psychotic bipolar disorder organic nature; /F06.32/ psychotic depressive disorder of organic nature; /F06.33/ psychotic mixed disorder organic nature; /F06.34/ hypomanic disorder of organic nature; /F06.35/ non-psychotic bipolar organic disorder nature; /F06.36/ non-psychotic depressive disorder of organic nature; /F06.37/ non-psychotic mixed disorder of organic nature. Excluded: - mood disorders (affective), inorganic nature or unspecified (F30 - F39); - right hemisphere affective disorders (F07.8x).

/F06.30/ Psychotic manic disorder

organic nature

F06.300 Psychotic manic disorder due to traumatic brain injury F06.301 Psychotic manic disorder due to cerebrovascular disease F06.302 Psychotic manic disorder due to epilepsy F06.303 Psychotic manic disorder due to a neoplasm (tumor) of the brain F06.304 Psychotic manic disorder due to human immunodeficiency virus (HIV infection)

Organic mental disorders (organic brain diseases, organic lesions brain) is a group of diseases in which certain mental disorders occur as a result of damage (damage) to the brain.

Causes of occurrence and development

Varieties

As a result of brain damage, various mental disorders gradually (from several months to several years) develop, which, depending on the leading syndrome, are grouped as follows:
- Dementia.
- Hallucinosis.
- Delusional disorders.
- Psychotic affective disorders.
- Non-psychotic affective disorders
- Anxiety disorders.
- Emotionally labile (or asthenic) disorders.
- Mild cognitive impairment.
- Organic personality disorders.

What do all patients with organic mental disorders have in common?

All patients with organic mental disorders in varying degrees impaired attention, difficulties in memorizing new information, slowed thinking, difficulty in setting and solving new problems, irritability, “getting stuck” on negative emotions, sharpening of traits previously characteristic of a given personality, and a tendency to aggression (verbal, physical) are expressed.

What is characteristic of certain types of organic mental disorders?

What to do if you discover the described mental disorders in yourself or your loved ones?

In no case should you ignore these phenomena and, especially, self-medicate! You must independently contact your local psychiatrist at the psychoneurological dispensary at your place of residence (a referral from the clinic is not needed). You will be examined, the diagnosis clarified, and treatment prescribed. Treatment of all mental disorders described above is carried out on an outpatient basis, by a local psychiatrist or in day hospital. However, there are cases when a patient needs to be treated in a 24-hour psychiatric hospital:
- at delusional disorders, hallucinosis, psychotic affective disorders, conditions are possible when the patient refuses to eat for morbid reasons, has persistent suicidal tendencies, aggressiveness towards others (as a rule, this happens if the patient violates the maintenance therapy regimen or completely refuses drug treatment);
- for dementia, if the patient, being helpless, was left alone.
But usually, if the patient follows all the recommendations of the doctors at the psychoneurological dispensary, his mental state is so stable that even with a possible deterioration there is no need to stay in a 24-hour hospital, the local psychiatrist gives a referral to a day hospital.
NB! There is no need to be afraid of going to a psychoneurological clinic: firstly, mental disorders greatly reduce a person’s quality of life, and only a psychiatrist has the right to treat them; secondly, nowhere in medicine is human rights legislation observed as much as in psychiatry; only psychiatrists have their own law - the Law of the Russian Federation “On psychiatric care and guarantees of citizens’ rights during its provision.”

General principles of drug treatment of organic mental disorders

1.Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by prescribing vascular drugs (medicines that dilate small arteries of the brain and, accordingly, improve its blood supply), medicines that improve metabolic processes in the brain (nootropics, neuroprotectors). Treatment is carried out in courses 2-3 times a year (injections, higher doses of medications), the rest of the time continuous maintenance therapy is provided.
2. Symptomatic treatment, that is, an impact on the leading symptom or syndrome of the disease, is prescribed strictly according to indications by a psychiatrist.

Is there a way to prevent organic mental disorders?

Ekaterina DUBITSKAYA,
Deputy Chief Physician of the Samara Psychoneurological Dispensary
on inpatient care and rehabilitation work,
Candidate of Medical Sciences, psychiatrist of the highest category

Description of organic disorders

Organic disorders - mental illness, which are characterized by persistent disruption of the brain, and, as a consequence, significant changes in the patient’s behavior. The patient suffers from mental exhaustion and decreased mental functions. As a rule, organic personality disorders manifest themselves in early age and make themselves felt for the rest of their lives. The course of the disease depends on age; the most dangerous periods are considered to be adolescence and menopause.

Hospitalization of a patient on a permanent basis is necessary only in cases where the patient begins to pose a danger to himself or to society

In most cases, organic disorders are chronic; in a small proportion of patients, the disease can progress and ultimately lead to social maladjustment. There are often cases when patients do not admit that they have a disease and persistently refuse medical help.

The consequences of organic disorders can be corrected

Causes of organic mental disorders

The most common cause of organic disorders is epilepsy: in patients suffering from epileptic seizures more than 10 years, the risk of developing an organic disorder is very high.

In addition to epilepsy, there are a number of reasons that can lead to the formation of an organic disorder:

• traumatic brain injuries
• encephalitis
• brain tumors
• multiple sclerosis
• use of steroids, hallucinogens and similar psychoactive substances
• chronic manganese poisoning
• brain infections
• vascular diseases

To diagnose an organic mental disorder, the doctor identifies emotional and characterological changes in the personality. MRI and EEG procedures are carried out, as well as a number of psychological tests

After epilepsy, the leading cause among the causes is occupied by head injuries, as well as damage to the temporal and frontal lobes of the brain.

We treat all types of organic disorders

Symptoms of organic mental disorders

The following symptoms are typical for patients suffering from organic disorders:

1. slow comprehension of what is happening, poor associative range, taciturnity
2. insensibility, lethargy
3. sharpening of character-forming personality traits
4. euphoria/dysphoria
5. unmotivated aggression, loss of control over impulses and impulses
6. stereotypical statements, monotony of jokes

After epilepsy, the leading cause among the causes is head injuries, as well as damage to the temporal and frontal lobes of the brain.

In the later stages of the disease, the patient is characterized by apathy, the appearance of serious problems with remembering and recalling information, which can ultimately lead to dementia.

Similar symptoms? Call toll-free line 8 800 555-05-99

Diagnosis of organic disorders

To diagnose an organic mental disorder, the doctor identifies emotional and characterological changes in the personality. MRI and EEG procedures are performed, as well as a number of psychological tests. To make a final diagnosis, the patient must exhibit at least two of the following symptoms for six months:

• noticeable decrease in performance
• problems with goal-directed activities
• instability of emotional states, sudden changes in mood
• antisocial manifestations
• change in speech rate, “getting stuck” on certain experiences
• change in sexual behavior
• paranoid ideas

Organic disorders are mental illnesses that are characterized by persistent disruption of the brain, and, as a result, significant changes in the patient’s behavior

You can make an appointment with a doctor 24 hours a day by calling 8 800 555-05-99

Treatment of organic disorders

Treatment of organic disorders is based on an accentuated effect on the factor that caused the disease. Depending on the symptoms, the attending physician prescribes drug therapy to relieve the external manifestations of the disease (this can be antidepressants, antipsychotics, anti-anxiety drugs, hormones), and also conducts a course of psychotherapy. Hospitalization of a patient on a permanent basis is necessary only in cases where the patient begins to pose a danger to himself or to society.

The most common cause of organic disorders is epilepsy

Thanks to the latest psychotherapeutic methods used in the Bekhterev center, our doctors will help the patient overcome obsessive states, depression, sexual problems caused by organic disorders. Individual, group and family therapy will give the patient the opportunity to build acceptable relationships with others and receive the necessary emotional support from relatives.

Treatment with us completely anonymous

Advantages of treatment at the Bekhterev center

Individual approach

Each of our patients is unique. Each treatment complex is unique. We are constantly improving our level of service, and this moment We offer you the following forms of treatment:

1. a doctor visiting your home for hangover relief, coding and consultations;
2. outpatient treatment (clinic visits for consultations, examinations and procedures);
3. inpatient treatment (staying in the clinic for 24 hours);
4. day hospital (a visit to the clinic for the whole day with the opportunity to return home in the evening).

We work 24 hours a day, seven days a week

Hospitalization in our center is possible at any time of the day. Our patients receive constant care and attention throughout their stay at the center, 24 hours a day.

High professionalism of doctors

We are extremely scrupulous in selecting quality specialists to work in our center. In addition to their high professional level, all our doctors love their work.

The price for a call increases if the call is in the suburbs (+500 rubles if the call is in the “Dema”, “Zaton”, “Shaksha” areas and the distance is up to 15 km (I zone), +1000 rubles the distance from Ufa is 15 - 30 km. ( II belt), +1500 rubles - distance from Ufa 30 - 70 km (III belt)

Our clinic employs highly qualified psychiatrists and psychotherapists, doctors with the highest and first qualification categories, candidates of medical sciences, and excellent healthcare workers of the Republic of Belarus.