Neuropsychological Mental Disorders

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Neuropsychological Mental Disorders

Psychoses :

• Psychoses are severe psychiatric illness with serious distortion of thought, behaviour, capacity to recognise reality and of perception (delusions and hallucinations) i.e. Psychosis is a symptom of mental illnesses characterized by a distorted or non-existent sense of reality
• There is inexplicable misperception and misevaluation; the patient is unable to meet the ordinary demands of life .
• Symptoms of psychoses are as follows :
  – Positive symptoms : hallucinations, delusions, disorganized thought, restlessness, insomnia, anxiety, fighting, aggression, disorganized speech, and disorganized or agitated behavior.
  – Negative symptoms : apathy, loss of insight and volition, avolition, alogia, affective flattening, poverty of speech, social withdrawal apathy.
• Psychoses can be divided into categories as follows :
  1. Organic brain syndromes (cognitive disorders) :
  – Acute and chronic
  – Prominent features are confusion, disorientation, defective memory and disorganized behaviour.
  – E.g. Delirium, dementia
  2. Functional disorders :
  – No underlying cause can be defined;
  – Memory and orientation are mostly retained but emotion, thought, reasoning and behaviour are seriously altered.
  – Following functional disorders are defined:
  • Schizophrenia (Split mind) : Schizophrenia is a type of chronic psychosis characterized by splitting of perception and interpretation from reality – delusions, hallucinations (often in the form of voices), and thinking or speech disturbances (inability to think coherently).
  • Paranoid states with marked persecutory or other kinds of fixed delusions ( false beliefs) and loss of insight into the abnormality.

Affective disorders :

• Affective disorders are characterised by alterations in mood state either Mania (elevated mood) or Depression (depressed mood).
  – Mania (elevated / irrited mood) is characterised by the opposite behavior : hyperactivity, enthusiasm, anger, rapid & uncontrollable thought and speech patterns, reduced sleep, extreme self-confidence, impaired judgment may be associated with reckless or violent behaviour.
  – Depression is characterised by feelings of sadness and hopelessness, loss of interest and pleasure, worthlessness, guilt, physical and mental slowing, melancholia, self-destructive ideation, changes in sleep patterns and appetite, loss of energy, and suicidal thoughts.
• Affective disorders are classified as follows:
  1. Unipolar disorder : Affective disorder characterised by one of mood state Mania or Depression (not both).
  2. Bipolar disorder : Affective disorder characterised by cyclically alternating mania & depression.

Depression :

• Depression is characterised by feelings of sadness and hopelessness, loss of interest and pleasure, worthlessness, guilt, physical and mental slowing, melancholia, self-destructive ideation, changes in sleep patterns and appetite, loss of energy, and suicidal thoughts.
• Depression can be classified in various types :
  1. Major depression (Endogenous depression / Major depressive disorder MDD / Unipolar depression) : It is characterised by depressive state only .
  2. Bipolar depression : It is characterised by manic depressive illness i.e. alternating depression with mania.
  3. Reactive depression : It is due to physical illness, loss, blow to self-esteem or bereavement, but is excessive or disproportionate.

Neuroses :

• Neuroses are less serious mental illness; ability to comprehend reality is not lost, though the patient may undergo extreme suffering.
• Depending on the predominant feature, it may be labelled as:
  • Anxiety : An unpleasant emotional state associated with uneasiness, discomfort, worry, tension, apprehension and concern or fear about some defined or undefined future threat.
  • Phobic states : Fear of the unknown or of some specific objects, person or situations.
  • Obsessive compulsive disorder (OCD) : Limited abnormality of thought or behaviour; recurrent intrusive thoughts or ritual like behaviours which the patient realizes are abnormal or stupid, but is not able to overcome even on voluntary effort i.e. Mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly (called “rituals”), or have certain thoughts repeatedly.
  • Post-traumatic stress disorder (PTSD) : Mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person’s life i.e. following distressing experiences like war, riots, earthquakes, etc.
  • Hysterical : Dramatic symptoms resembling serious physical illness, but situational, and always in the presence of others; the patient does not feign but actually undergoes the symptoms, though the basis is only psychic and not physical.

Autism :

• Autism is a disease whose neuropathology is incompletely understood, but in some patients is associated with explosive behavioral outbursts, and aggressive or self-injurious behaviors that may be stereotypical.