Neurological and mental disorders
comparison, common points
In the fascinating complexity of how we function as humans, there is a crucial intersection between the neurological and psychiatric spheres. This article brings a reality to the fore – mental disorders coexist with neurological pathologies, and in addition, they affect a significant part of the population globally.
In the light of current knowledge, 14 major types of neurological disorders have been identified, showing the presence of a clinical picture similar to that seen in psychiatric diseases and disorders.
Psychiatric disorders or conditions arising from neurological causes are emerging as a result of brain damage or the development of neurological conditions, thus highlighting the need for an integrative approach to understanding and treating the complex connections between mind and body.
Neurological disorders >> Psychiatric symptoms
Most common symptoms, syndromes, clinical psychiatric manifestations in neurocognitive disorders (NCDs) are:
- Disturbances of conscience
- Pathological mental status
- Classic signs of cognitive impairment
- Perceptual disturbances (visual, tactile, gustatory, olfactory hallucinations)
- Signs of subcortical dysfunction (motor disorders, tremor, ataxia, choreic movements)
- Untidy appearance, poor hygiene
Mental disorders occur most commonly in diseases such as Parkinson’s, Wilson’s, Huntington’s, iatrogenic syndromes, neuroleptic parkinsonism.
In the clinical picture of these neurological diseases, the most common comorbid symptoms are aphasia, agnosia (visual, optical, colour, facial), stereognosia, apraxia, amnesia, unilateral spatial neglect (NSU), dementias, deterioration of memory, cognitive functions, language disorders.
Pathology of anatomical functionality can be found depending on the affected area of the brain. In pathologies of certain affected areas of the brain, specific neurological pathologies and comorbid mental symptoms may be observed.
Comorbid neurological and psychiatric symptoms according to different affected areas of the brain:
FRONTAL SYNDROME
- unilateral loss of smell
- apathy
- indisposition
- decreased ability to communicate spontaneously
- impulsive aggressive dysphoric behaviour
- inability to self-control certain motor movements
- imitative behaviour (Lhermitte behaviour)
- visual disturbances
- memory disorders vegetative disorders
- motor aphasia
PARIETAL SYNDROME
- epilepsy
- hemianaesthesia
- unilateral disorders of body parts
- right-left disorientation
- difficulty orienting in space
- dressing apraxia
- short-term amnesic deficit
- alexia (inability to read)
- agraphia (loss or disturbance of the function of expressing thoughts in writing)
- dysgraphia (pathological disturbance of handwriting, which becomes distorted and unreadable)
- Anton Babinski syndrome
- Gertsmann syndrome
- taste disorders
TEMPORAL SYNDROME
- total or partial blindness
- visual agnosia (loss or disturbance of intellectual functions of recognition of what is seen, heard, touched)
- scotoamas (loss of vision in a limited portion of the visual field)
- optical illusions
- palynopsia (a vision condition in which the patient continues to see, intermittently, an object that has disappeared from his or her field of vision)
- olfactory disorders
- hallucinations
- taste disorders
- upper quadrant hemianopia (weakening or loss of vision in one half of each retina, seen in some nerve diseases)
- temporal epilepsy
- somatosensory seizures
- olfactory crises
- deja vu sensations
- illusions
- time perception deficit
- memory impairment
- language disorders
- Disturbances of conscience.
OCCIPITAL SYNDROME
- visual hallucinations
- hemianopsia (weakening or loss of vision in one half of each retina, found in some nerve diseases)
- Prozopagnosia (loss of the ability to recognize physiognomies)
- colour anosmia
- Balint syndrome
- optic ataxia symultagnotia (disorder of coordination of voluntary movements due to damage to nerve pathways or nerve centres)
Neurological and psychiatric disorders >> Psychiatric symptoms
Most common psychiatric symptoms and syndromes often found in mental and neurological disorders are:
- Cognitive disorders and thought operations (fixation amnesia, decreased attention, black-out, reduced vocabulary, verbal clichés, loss of ideational flexibility and operational thinking abilities):
- Alterations of consciousness (short and long-lasting confusion);
- Personality disorders (impulsive, aggressive, apathetic behaviour);
- Perceptual disturbances (visual hallucinations in organic conditions, e.g. delirium, epilepsy);
- Mood disorders (depression, anxiety, emotional lability, e.g. vascular pathology, multiple sclerosis, Alzheimer’s disease, dementia)
Psychiatric disorders caused by neurological diseases
The most common psychiatric disorders in neurological diseases according to Kurt Schneider are the following pathologies:
- Cognitive syndromes (dementia syndrome, delirium, organic amnestic disorder);
- Schizophreniform disorders and other organic psychiatric syndromes (organic psychotic disorder);
- Organic affective disorder;
- Organic anxiety disorder;
- Organic sexual dysfunction.
- Organic Catonic Disorder;
- Organic personality disorder
MAIN NEURO-PSYCHIATRIC DISORDERS
ALZHEIMER’S DEMentia – Mental and neurological disorders
In dementia, other areas of mental activity are also affected, such as memory – progressive amnesia, initially anterograde (retaining old memories), language, orientation (disorientation in space is initially temporal, later spatial, patients do not remember their name, address, family members), emotional or personality disorders, cognition.
Clinical picture is characterised by: change in behaviour, inappropriate social behaviour, aggression, irritability and anger, affective disorders or apathy, memory regression, slow thinking, impaired expression and comprehension, language and recognition disorders; inability to eat, inability to dress oneself, physical activities in the daily routine are affected, hallucinations, delusions.
Alzheimer’s disease is defined as a cognitive disorder, thus non-cognitive psychiatric complications are associated (depression, anxiety, insomnia, hallucinations, delusions, sexual and behavioural disorders, etc.) and neurological.
The most common neuropsychiatric symptoms in Alzheimer’s disease:
- Apathy 50-70 %
- Agitation 40-65%
- Anxiety 30-50%
- Irritability 30-45%
- Depression 40%
- Disinhibition 30-40%
- Delusional ideas 20-40%
- Insomnia 20-25
- Hallucinations 5-15%
LEWY BODY DISEASE
In mental disorders in Lewy body disease most often we can see a progressive cognitive deficit, depression, hallucinations and delusions
PARKINSON’S DISEASE
Mental and neurological disorders in Parkinson’s disease are manifested by:
- rest tremor
- rigidity
- postural instability and gait impairment
- autoimmune disorders
- mood disorders (anxiety, depression)
- speech impediments
- cognitive impairment
- dementia
- sleep disturbances
HUNTINGTON’S DISEASE
The clinical picture of Huntington’s disease includes:
- uncontrolled movements,
- clumsiness or balance problems
- mood changes (irritability, anxiety, apathy, passivity, depression or anger)
- cognitive impairment, inability to drive, remembering new things, remembering them or episodes previously experienced, inability to judge and make decisions, decreased memory
- clinical schizophrenic form with delusions
- perceptual disturbances
BRAIN DISORDERS – Mental and neurological disorders
In these disorders are specific:
- disorders of consciousness (obnubilation – a state of apathy, general physical and mental numbness, with slowing of thought, caused by some diseases of the nervous or cardiovascular system, drowsiness with a concomitant symptomatology – slowing of thought, disorientation, reactions only to strong stimuli).
Cerebral Vascular Accident (CVA) – Mental and neurological disorders
The most common post-stroke symptoms and syndromes are:
- mood disorders, vascular depression (anhedonia, guilt, cognitive impairment and psychomotor inhibition);
- depression, comorbid with dementia (cognitive symptoms, pseudodementia);
- dementia (amnesia, apraxia, visual-spatial dysfunction, cognitive disorganisation, language deficit, disinhibited behaviour, apraxia, paranoia, reduced social functioning);
- symptoms of depression (sleep disturbances, disturbed concentration, lack of appetite, lack of motivation, lack of energy, easy crying, guilt, pessimism, nihilism);
- psychotic symptoms (delirium, thought disorders, perceptual disorders – visual, auditory).
MYASTHENIA GRAVIS
The most common symptoms and syndromes found here are:
- muscle weakness (dysarthria, dysphagia, motor difficulties);
- ocular symptoms (blepharospasm, ptosis, photophobia, diplopia);
- bulbar symptoms;
- affective symptoms (depression, anxiety, sadness, fear, imminent catastrophe, mental anaesthesia, apathy, dysphoria);
- cognitive dysfunction;
- phobias;
- self-aggressive, compulsive behaviour;
- lower quality of life.
PATIENTS WITH HIV – Mental disorders
The most common psychiatric syndromes in patients with HIV infection are:
- cognitive or psycho-organic syndrome (memory decline, cognitive decline, unstable emotional phonus);
- dementia syndrome (decreased cognition with ataxia, apraxia, hypertonia, paraparesis);
- affective syndromes (depression, manic or hypomanic episode);
- psychotic episodes.
CONCLUSION
Mental disorders occur at a very high rate in neurological pathologies and affect a large part of the world’s population. To date, 14 types of major neurological disorders are known, with a clinical picture similar to that of psychiatric diseases and disorders, which occur as a result of damage to the human brain or as a result of the development of neurological diseases.
Bibliography
Boșcanean Cristina, Boronin Larisa, Psychological disorders in neurological diseases, 2023, pp. 368-375
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