Abstract
In the current chapter, the neuropsychological profile of various neurological and psychiatric conditions is focused on, including two major divisions (i.e., dementia—cortical and sub-cortical—and major mental disorders—substance use disorders, mood disorders, anxiety disorders, psychotic disorders, sleep disorders, childhood disorders, personality disorders, and sexual disorders). Both divisions have sub-classifications that include introduction, etiopathogenesis, epidemiology, clinical features, evaluation, treatment, and psychosocial aspects.
TopIntroduction
Dementia is a progressive impairment in the functions of the brain especially of the cognitive domain when there is clear conscious. This leads to decline in the previously learned things in more than one domain’s executive function, attention, language, memory, complex motor tasks, following social norms. These will lead to decline in the level of functioning. Dementia is derived from a Latin word Dementatus meaning out of one’s mind (Sadock, Kaplan & Sadock, 2005). It was first used by Celsius in 1st century AD, till 19th century there was no much knowledge (Jellinger, 2010). Esquirol also described hallucinations, delusions, and aggressive behavior motor impairments in dementia patients. In 1907 Alois Alzheimer was the first person to identify histopathological changes associated with progressive degenerative dementia.
Etiopathogenesis: The etiopathogenesis are diverse including degenerative disorders, medical illness, infections, substance induced and combination of these. Histopathologically the presence of neurofibrillary tangles and plagues in the cortex and brainstem; Fig: 1, this is seen in 42% of patients with Alzheimer dementia, Lewy Body dementia is seen in 15 to 35 percent (Kotzbauer, Trojanowsk, & Lee, 2001). The second most common dementia and most common below the age of 65 is fronto-temporal degenerative dementia. The causes of dementia are Neurodegenerative, Vascular, Neurological diseases, Endocrine, Nutritional, infectious, Metabolic, Traumatic, Exposure to substances like Alcohol, Irradiation. Minimum cognitive impairment - amounts to discrete loss of cognitive functions but not meeting the criteria of the dementia disorder as such. This also has some mood influences also.
Figure 1.
Insoluble fibrillar Aβ plaques begins in neocortex
ICD - 10 Criteria for Diagnosis of Dementia
- 1.
Presence of a dementia symptoms and signs.
- 2.
Insidious onset with slow deterioration. While the onset usually seems difficult to pinpoint in time, realization by others that the defects exist may come suddenly. An apparent plateau may occur in the progression.
- 3.
Absence of clinical evidence, or findings from special investigations, to suggest that the mental state may be due to other systemic or brain disease which can induce a dementia (e.g. hypothyroidism, hypercalcaemia, vitamin B12 deficiency, niacin deficiency, neurosyphilis, normal pressure hydrocephalus, or subdural haematoma).
- 4.
Absence of a sudden, apoplectic onset, or of neurological signs of focal damage such
- 5.
As hemiparesis, sensory loss, visual field defects, and incoordination occurring early in the illness (although these phenomena may be superimposed later).
Key Terms in this Chapter
Acetylcholine: (ACh) is an organic chemical that functions in the brain and body of many types of animals (and humans) as a neurotransmitter—a chemical message released by nerve cells to send signals to other cells, such as neurons, muscle cells, and gland cells.
Obsessive-Compulsive Disorder (OCD): Is a mental illness that causes repeated unwanted thoughts or sensations (obsessions) or the urge to do something over and over again (compulsions). Some people can have both obsessions and compulsions.
Anxiety: Anxiety is your body's natural response to stress. It's a feeling of fear or apprehension about what's to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous
Psychosis: Is an abnormal condition of the mind that results in difficulties determining what is real and what is not. Symptoms may include false beliefs (delusions) and seeing or hearing things that others do not see or hear (hallucinations).
Dementia: Is a syndrome in which there is deterioration in memory, thinking, behaviour, and the ability to perform everyday activities. Although dementia mainly affects older people, it is not a normal part of ageing
Mania: Also known as manic syndrome , is a state of abnormally elevated arousal, affect, and energy level, or a state of heightened overall activation with enhanced affective expression together with lability of affect. Although mania is often conceived as a “mirror image” to depression, the heightened mood can be either euphoric or irritable; indeed, as the mania intensifies, irritability can be more pronounced and result in violence, or anxiety.
Substance Use: The term “substance use” refers to the use of drugs or alcohol, and includes substances such as cigarettes, illegal drugs, prescription drugs, inhalants and solvents. A substance use problem occurs when using alcohol or other drugs causes harm to you or to others. Substance use problems can lead to addiction.
Dopamine: (DA, a contraction of 3,4-dihydroxyphenethylamine) is an organic chemical of the catecholamine and phenethylamine families. It functions both as a hormone and a neurotransmitter, and plays several important roles in the brain and body.
Serotonin: Is a chemical nerve cells produce. It sends signals between your nerve cells. Serotonin is found mostly in the digestive system, although it's also in blood platelets and throughout the central nervous system. Serotonin is made from the essential amino acid tryptophan.
Depression: Depression is the main cause of disability worldwide, according to the World Health Organization (WHO). It can affect adults, adolescents, and children.