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Causes of organic mental disorders. Organic and symptomatic mental disorders

And I would like to start with one not very well-known 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 F06 (Other mental disorders caused by 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. 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 leading article in scientific magazine 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. The new classification will include a subheading: “Secondary mental or behavioral syndromes associated with disorders or diseases classified in other headings.” 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 least 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.

Organic personality and behavior disorder can develop after receiving a certain type of brain injury, as well as some inflammatory and non-inflammatory diseases. A person’s behavior undergoes serious changes, the emotional sphere is affected, as well as the ability to control impulsive behavior

To make such a diagnosis, ICD-10 requires, in addition to determining evidence of disease, dysfunction, or brain injury, to also identify the presence of at least two of these criteria:

  1. Decreased performance;
  2. Tendency to affective manifestations;
  3. Paranoid ideas and suspicion;
  4. Impaired judgments about the social sphere;
  5. The fluency and pace of speech changes;
  6. The nature of sexual behavior is changing.

Forms of the disease and its symptoms

Organic mental disorders manifest themselves in the following forms:

  1. Organic emotional labile asthenic disorder. The main clinical manifestation of this pathology is asthenic syndrome, which is characterized by weakness, hypersensitivity, decreased motor skills, dizziness, irritability, tearfulness, and fatigue.
  2. Asthenic organic disorder– this is a persistent change in the psyche, which combines neurosis-like and cerebrasthenic syndromes, which is characteristic of vascular diseases of the brain. It appears at the beginning of the disease and persists until the final stage - vascular.
  3. Symptomatic mental disorders are a fairly typical manifestation of somatic diseases, sometimes even their main syndrome. It is expressed in difficulty concentrating, increased fatigue, delayed perception, weakened memory, and mental vulnerability. Patients also suffer from hyperesthesia, sleep disturbances, and multiple vegetative manifestations.
  4. . Clinical manifestations of this pathology are tremor, a feeling of trembling in the epigastrium, increased heart rate, hypertension, pallor, dry mouth, anxiety and panic, which the patient does not associate with any reason.
  5. Schizophrenia-like disorder is characterized, which is either constantly present or occurs periodically, by negative personality changes, the appearance of hallucinatory-delusional images, often of religious subjects. Possible disturbances of consciousness, paraphrenia, which are characterized by ecstasy, excitement and statements of a messianic plan.
  6. Exogenously organic disorders can be psychopathic and neurosis-like. They manifest themselves in the form of pronounced intellectual-mnestic, depressively colored vegetative disorders, as well as in the form of uncontrollability, conflict and anger.
  7. personalities found in the practice of both neurologists and therapists. Its peculiarity lies in the predominance of somato-neurological symptoms over mental ones. Sleep disturbances, increased fatigue, memory problems, appetite disorders, dry mouth, and increased urination are observed.
  8. Affective disorder develops mainly against the background of pathologies of the endocrine glands (thyrotoxicosis, thyroidectomy, Itsenko-Cushing's disease), upon discontinuation of hormonal drugs used for their treatment for a long time, as well as tumors of the frontal lobe of the brain and traumatic brain injuries. Manifests itself in the form of various affective disorders.
  9. Speech disorders They occur both in childhood, due to various developmental pathologies, and in adults, due to cerebral atherosclerosis, diabetes mellitus and hypertension.
  10. Residual organic disorders occur in adolescence and childhood as a consequence of organic cerebral pathology. They manifest themselves as mental retardation, as well as various psychogenic characterological and pathocharacterological reactions.
  11. Vascular disorder develops as a consequence of various types of vascular diseases of the brain - atherosclerosis, thromboangiitis obliterans, hypertension and certain vascular pathologies, for example, myocardial infarction. The symptoms of this type of mental disorder differ from other similar pathologies in the almost complete absence of pronounced psychopathology and the predominance of neurological disorders.
  12. Personality disorder of complex origin. This diagnosis is made when there is more than one cause for the development of this pathology.

Diagnosis of pathology

The diagnosis of this pathology is established on the basis of a complete comprehensive examination of the patient. Should also be carried out differential diagnosis with, the most important distinguishing feature is memory impairment (the only exception to this rule is Pick's disease). The most accurate diagnostic criterion is the results of a neuropsychological examination; neurological data, EEG and CT are also of great importance.

Eligibility criteria for recruits diagnosed with organic personality disorder

Such examination is also of great importance for conscripts. After all, with such a diagnosis as personality disorder, The fitness category is set depending on the severity of the disease. Conscripts are examined at an outpatient clinic or inpatient department. There is a technology that involves the use of special tables for differential diagnosis, with the help of which it is quite easy to determine whether or not a person has nervous system disorders. The experience of clinical application of this technique in psychiatric hospitals has shown its exceptional information value for making a decision by an expert military medical commission of adolescents regarding their suitability for military service.

Treatment

This disease requires careful examination and careful, long-term, complex therapy. Treatment is carried out using medications and psychotherapeutic techniques. These types of therapy should not be opposed to each other. However, medications do not play such a significant role in the treatment of patients with such pathologies. Antipsychotics in small doses should be used in cases of aggression or psychomotor agitation, as well as decompensated paranoid disorder (for example, haloperidol or levomepromazine). Anxiolytic drugs(such as diazepam) can reduce anxiety. (amitriptyline) are needed, respectively, in the presence of a depressive state. The best method of treating such diseases is psychotherapy - individual, psychoanalytic, family or group. With the help of this method, the patient’s attitudes change, he finds the right interpersonal relationships with others.

Course of the disease and its prognosis

Adaptation of patients in the outside world depends on how disrupted their behavior is, as well as on a number of external factors. Patients adapt more easily in the presence of favorable external conditions, and the condition worsens if they encounter unfavorable ones. Factors causing decompensation are infectious and somatic diseases, stress and intoxication. The development of psychopathy depends on the age of the patient. The period of puberty is considered the most problematic. A common feature of each of these types of pathologies is non-progressiveness. But at the end of the period of decompensation, the patient’s personality returns to its original state. Patients usually try to avoid taking a course of treatment. The disease is chronic and progressive, gradually leading the patient to his social and labor decompensation, but the condition of some patients may improve.

Organic mental disorders (organic brain diseases, organic brain lesions) are 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 have varying degrees of attention impairment, difficulty in remembering new information, slowed thinking, difficulty in setting and solving new problems, irritability, “getting stuck” on negative emotions, sharpening of features previously characteristic of a given person, a tendency to aggression (verbal, physical).

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. Therapy for all the mental disorders described above is carried out on an outpatient basis, by a local psychiatrist or in a day hospital. However, there are cases when a patient needs to be treated in a 24-hour psychiatric hospital:
- with 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 the Rights of Citizens in 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), drugs 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

Organic personality disorder is a persistent disorder of the brain caused by an illness or injury that causes a significant change in the patient's behavior. This condition is marked by mental exhaustion and decreased mental functions. Disorders are detected in childhood and can persist throughout life. The course of the disease depends on age and critical periods are considered dangerous: puberty and menopause. Under favorable conditions, stable compensation of the individual can occur with saving ability to work, and if negative influences occur (organic disorders, infectious diseases, emotional stress), there is a high probability of decompensation with pronounced psychopathic manifestations.

In general, the disease has a chronic course, and in some cases it progresses and leads to social maladjustment. By providing appropriate treatment, the patient's condition may improve. Often patients avoid treatment without recognizing the fact of the disease.

Causes of organic personality disorder

Organic disorders due to a huge number of traumatic factors are very common. The main causes of disorders include:

- injuries (craniocerebral and injuries to the frontal or temporal lobe of the head;

— brain diseases (tumor, multiple sclerosis);

- infectious brain lesions;

- vascular diseases;

— encephalitis in combination with somatic disorders (parkinsonism);

- cerebral palsy;

— chronic manganese poisoning;

- temporal lobe epilepsy;

- use of psychoactive substances (stimulants, alcohol, hallucinogens, steroids).

In patients suffering from epilepsy for more than ten years, an organic personality disorder is formed. It is hypothesized that there is a relationship between the degree of impairment and the frequency of seizures. Despite the fact that organic disorders have been studied since the end of the century before last, the features of the development and formation of symptoms of the disease have not been fully identified. There is no reliable information about the influence of social and biological factors on this process. The pathogenetic link is based on brain lesions of exogenous origin, which lead to disturbances in inhibition and the correct balance of excitation processes in the brain. Currently, the most accurate approach is considered to be an integrative approach in detecting the pathogenesis of mental disorders.

The integrative approach assumes the influence of the following factors: socio-psychological, genetic, organic.

Symptoms of organic personality disorder

The symptoms are characterized by characterological changes, expressed in the appearance of viscosity, bradyphrenia, torpidity, and sharpening of premorbid features. The emotional state is noted to be either unproductive or unproductive; emotional lability is also characteristic of the later stages. The threshold in such patients is low, and an insignificant stimulus can provoke an outbreak. In general, the patient loses control over impulses and impulses. A person is not able to predict his own behavior in relation to others; he is characterized by paranoia and suspicion. All his statements are stereotypical and are marked by characteristic flat and monotonous jokes.

At later stages, organic personality disorder is characterized by dysmnesia, which can progress and transform into.

Organic personality and behavior disorders

All organic behavioral disorders occur after a head injury, infection (encephalitis) or as a result of a brain disease (multiple sclerosis). There are significant changes in human behavior. Often the emotional sphere is affected, and the person’s ability to control impulsiveness in behavior decreases. The attention of forensic psychiatrists to the organic disorder of human behavior is caused by the lack of control mechanisms, increased self-centeredness, as well as the loss of socially normal sensitivity.

Unexpectedly for everyone, previously benevolent individuals begin to commit crimes that do not fit into their character. Over time, these people develop an organic cerebral condition. Often this picture is observed in patients with trauma to the anterior lobe of the brain.

Organic personality disorder is taken into account by the court as a mental illness. This illness is accepted as a mitigating circumstance and is the basis for referral for treatment. Often problems arise in antisocial individuals with brain injuries that exacerbate their behavior. Such a patient, due to an antisocial, stable attitude towards situations and people, indifference to consequences and increased impulsiveness, can appear very difficult for psychiatric hospitals. The matter can also be complicated by the subject’s anger, which is associated with the fact of the disease.

In the 70s of the 20th century, researchers proposed the term “episodic loss of control syndrome.” It has been suggested that there are individuals who do not suffer from brain damage or epilepsy, but who are aggressive due to a deep organic personality disorder. Moreover, aggressiveness is the only symptom of this disorder. The majority of people with this diagnosis are men. They have long-term aggressive manifestations that go back to childhood, with an unfavorable family background. The only evidence in favor of such a syndrome is EEG abnormalities, especially in the temple area.

It has also been suggested that there is an abnormality in the functional nervous system leading to increased aggressiveness. Doctors have suggested that severe forms of this condition are due to brain damage, and they can persist into adulthood and also manifest themselves in disorders associated with irritability, impulsivity, lability, violence and explosiveness. According to statistics, a third of this category had an antisocial disorder in childhood, and in adulthood most of them became criminals.

Diagnosis of organic personality disorder

Diagnosis of the disease is based on identifying characterological, typical emotional, as well as cognitive changes in personality.

To diagnose organic personality disorder, the following methods are used: MRI, EEG, psychological methods (Rorschach test, MMPI, thematic apperception test).

Organic disorders of brain structures (trauma, disease or brain dysfunction), the absence of memory and consciousness disorders, and manifestations of typical changes in the nature of behavior and speech are determined.

However, for the reliability of the diagnosis, long-term observation of the patient, at least six months, is important. During this period, the patient must show at least two signs of an organic personality disorder.

The diagnosis of organic personality disorder is established in accordance with the requirements of ICD-10 if two of the following criteria are present:

- a significant decrease in the ability to carry out purposeful activities that require a long time and do not lead to success so quickly;

- altered emotional behavior, which is characterized by emotional lability, unjustified fun (euphoria, easily turning into dysphoria with short-term attacks and anger, in some cases a manifestation of apathy);

- drives and needs that arise without taking into account social conventions and consequences (antisocial orientation - theft, intimate claims, gluttony, failure to comply with personal hygiene rules);

- paranoid ideas, as well as suspicion, excessive preoccupation with an abstract topic, often religion;

- change in tempo in speech, hypergraphia, over-inclusion (inclusion of side associations);

- changes in sexual behavior, including decreased sexual activity.

Organic personality disorder must be differentiated from dementia, in which personality disorders are often combined with memory impairment, with the exception of dementia with. The disease is more accurately diagnosed on the basis of neurological data, neuropsychological examination, CT and EEG.

Treatment of organic personality disorder

The effectiveness of treatment for organic personality disorder depends on an integrated approach. What is important in treatment is a combination of medication and psychotherapeutic effects, which, when used correctly, enhance each other’s effects.

Drug therapy is based on the use of several types of drugs:

- anti-anxiety drugs (Diazepam, Phenazepam, Elenium, Oxazepam);

- antidepressants (Clomipramine, Amitriptyline) are used in the development of a depressive state, as well as exacerbation of obsessive-compulsive disorder;

- neuroleptics (Triftazine, Levomepromazine, Haloperidol, Eglonil) are used for aggressive behavior, as well as during the period of exacerbation of paranoid disorder and psychomotor agitation;

— nootropics (Phenibut, Nootropil, Aminalon);

— Lithium, hormones, anticonvulsants.

Often, medications only affect the symptoms of the disease, and after stopping the drug, the disease progresses again.

The main goal in the use of psychotherapeutic methods is to weaken the patient’s psychological state, help in overcoming intimate problems, depression, and learning new behavior patterns.

Help is provided for both physical and mental problems in the form of a series of exercises or conversations. Psychotherapeutic influence using individual, group, and family therapy will allow the patient to build competent relationships with family members, which will provide him with emotional support from relatives. Placing a patient in a psychiatric hospital is not always necessary, but only in cases where he poses a danger to himself or to others.

Prevention of organic disorders includes adequate obstetric care and rehabilitation in the postnatal period. Proper upbringing in the family and at school is of great importance.

I'm interested in this question. How can a moderately severe organic personality disorder be diagnosed in connection with prenatal pathology at the age of 18 during an examination from the military registration and enlistment office a week in advance, if according to medical data. cards from the children's clinic, the child was born full-term, the neonatal period without pathologies, Apgar score 8/9 points, in the first year he grew and developed according to age, examined by a neurologist at 2 months - healthy? Or is this a universal diagnosis for all conscripts who at least once turned to a psychiatrist in childhood and the psychiatrist does not want to risk sending them to the army? Judging by the comments, this universal diagnosis can be given to anyone, at the discretion of the psychiatrist. And for this, as you write, you don’t need to be observed for half a year.

Hello! I had a problem when applying for a job (civil service). In the certificate, the psychiatrist indicated that I was referred by a therapist to undergo medical examination for the main disease diabetes mellitus and diagnosed F07.09. I didn’t know about this diagnosis, I didn’t undergo any examinations, I don’t have any complaints or violations corresponding to this disease, I work as an engineer, my characteristics are good, I drive a car. In 2013 I suffered a stroke, recovered quickly and went back to work, at about the same time I came to the ITU commission, there were no complaints of speech disorder, dementia, poor memory, no insomnia, there was a slight numbness in my left hand and a headache, which went away after a while, I was not observed by a psychiatrist and did not seek help; I did not undergo any examinations confirming such a diagnosis. Please tell me who can remove the diagnosis, or whether it is necessary to go to court, because the medical commission offered to go to all the necessary examinations and specialists on a paid basis.

  • Hello, Yulia. To get a diagnosis removed, you need to talk to your psychiatrist. Usually, to remove the diagnosis, the patient is sent to a psychiatric hospital for a psychiatric false examination; psychiatrists do not make such decisions alone. Before starting active actions against PND, it is better to bypass all psychiatrists and if you find sympathy from someone, try to go to him. Young psychiatrists are more responsive.
    There is a lawyer at the PND, you can contact him, but you must remember that he protects the PND, not you. But in any case, he will give information and will remember the law.
    So that with the manager It was easier for the PND to find a common language; you can immediately inform him of your determination to go to the end, to the court, in which you will appeal, among other things. and his actions or inactions. You just need to act judiciously: calmly, persistently, but without aggression and emotions. Try to focus on common interests - neither the IPA nor you need unnecessary hassle and problems. In this case, you need to follow the rules: you should not show behavior that will cause the psychiatrist to analogize it with the symptoms of psychiatric diagnoses, otherwise the psychiatrists may aggravate you right there. You can first contact any paid psychiatrist for a certificate of mental health. This certificate does not oblige anyone to anything, but it will help PND psychiatrists relieve themselves of responsibility and show that you will have serious arguments in court. If the issue is not resolved, then you can further go to court or the prosecutor's office. What documents the prosecutor's office will require will be decided by themselves and requested from the PND. For the court, you need to competently draw up a claim and provide evidence of your case. To do this, you need advice from a lawyer or lawyer. The lawyer draws up a statement of claim to recognize the diagnosis of a mental disorder as unfounded. In any case, the court orders a forensic psychiatric examination to confirm or refute the false diagnosis.
    In the pleading part of the statement of claim, it is necessary to ask the court not only to recognize the false psychiatric diagnosis as unfounded, but also to ask the court to oblige the PND to “remove” (cancel) the previously issued false diagnosis.

Hello, at the age of 22 I was diagnosed with a personality disorder of organic etiology and was treated as a day patient. Now for me the issue of work is extremely difficult, the fact is that the contrast of my mood is very frequent and extreme in its maxims. Euphoria then depression, all this can happen day after day, therefore I practically cannot work at all, because it is not only mentally inconvenient to carry out any activity, but also physical suffering is terribly disturbing during activities. And who knows that during depressive episodes it is absolutely unrealistic to do anything, everything falls out of hand, everyone is angry with you, ready to annoy you, shout, insult and humiliate you. It used to be like this when I worked. While I’m in euphoria, everything is fine, I show excellent results, there are a lot of sales, people like everything, as soon as the emotional background has changed, then for my colleagues I’m immediately enemy number one, people blame everything and in this state it’s difficult to do anything about what’s happening, you can only say let's talk tomorrow or when I feel better. I told the doctor that I cannot carry out work; I have been looking for a job for three months, all to no avail. I was told that I needed to stay in the hospital for 2-4 months before being given a referral for medical examination. I can't go there yet. But the doctor also added to me that I was not very sick and they would most likely refuse to establish a disability group for me. It’s a very interesting situation, I can’t function and I can’t even count on the third disability group. So I live on the support of my girlfriend and I can’t do anything. Tell me, is it worth going to the clinic for examination?

  • Hello, Daniil. You can simply undergo an examination at a clinic for yourself, get recommendations on your condition and drug treatment. Regarding the group: You were given a specific answer under what conditions a referral to MTU is issued and a disability group is established.

Hello. In 2008, he passed the draft board, was recognized as “B” - limitedly fit for military service, according to Article 14-b (mental disorders with moderately severe mental disorders), exempted from conscription for military service and enlisted in the reserve of the RF Armed Forces. The diagnosis was made at a recruiting station during a military medical commission (after a 2-3 minute examination by a psychiatrist), but was not sent to a hospital for examination. When making a conclusion about my fitness for military service, the doctor had no information that I suffer from the indicated diseases (because I do not suffer from them), just as the pre-conscription commission had no complaints about my health. Due to my youthful immaturity and frivolity, I had no idea what difficulties I might encounter in the future when finding a job after receiving an education with this diagnosis. The military registration and enlistment office refuses to re-examine me; they say they are not obligated. (afraid of getting hit) They don’t admit you to a regional psychiatric clinic without a referral from the military registration and enlistment office to review the diagnosis. (I would even agree to compensation in order to receive a fitness category of “B” - fit with minor restrictions). Not a draft dodger, he did not deliberately “mow”; during the conscription, he studied in absentia. Please advise what can be done in this situation; 3 years of attempts to change the fitness category were in vain.

  • Hello, Alexander. Theoretically, the diagnosis can be removed after five years, of which the patient should be under the supervision of a specialist for a year. In this case, the latter must cancel therapy. With your diagnosis, you can be seen by a psychiatrist at your place of residence, who will help you in solving your problem.

    Good afternoon. Go to your local dispensary. You will be referred for examination to a medical doctor. A psychologist, or you need to go to the hospital for an examination. Let them prove it. Let them assemble a commission headed by the chief physician. In general, everything needs to be resolved at the local mental hospital

    • Thank you for your answer, but the hospital said that we are waiting for you with a referral from the military registration and enlistment office (as I said earlier, the military registration and enlistment office does not give a referral) or with a court decision to order a forensic medical examination. A lawsuit is currently being prepared. I ask you to answer one more question: At the legislative level, were I required to be examined in a hospital under Article 14-b (organic mental disorders with moderately severe mental disorders) or can such a diagnosis be made during an examination by a psychiatrist (as in my case). We need a rule of law.

Good afternoon. My husband had a head injury at birth (his skull was reset). According to his mother, no diagnosis was given to him. As a child, I was a very calm child. But amid a family tragedy during his school years, he got away with it and left home. The relationship with my mother deteriorated greatly. There was promiscuity and infectious diseases. There were also drugs. But in the end everything became a thing of the past. However, he experiences strong aggression towards women. He severely beat and abused his ex-girlfriend, the same situation happened to me. Very often he promises, swears that he will be with me, then abruptly takes back his words. He says that his family is pulling him back, that he is a lone wolf and a bright, rich future awaits him, and he followed him. Then he does something bad, comes back and asks to forgive everything. He loves to talk about religion, but he doesn’t follow anything himself. categorically does not want children. I observed a pattern that all these exacerbations of aggression, irritability and withdrawal occur twice a year like clockwork: from February-March, and then August-November. Sometimes there is an outbreak in July, but not severe. I've been watching this for six years. I tried to give sedatives, including fenozypam. At this time he was calm, with a family man. I didn't suffer from insomnia. Tell me, based on the symptoms, can what is happening to him be attributed to a mental disorder and specifically to an organic one?

While serving in the army, I suffered from shell shock. In 1992, a diagnosis was made: organic damage to the central nervous system of traumatic origin, astheno-depressive syndrome with vegetative crises, moderate - mixed hydrocephalus. I was in the third disability group. This year the group was removed. My condition is such that I cannot work. Previously worked as a graphic designer. Filed an appeal with the central regional MREC. True, in our district clinic they said that the disability would not be restored and it was a waste of time. I don’t know what to do. Fainting and severe depression began. Maybe you can tell me how to restore my disability group. Thanks in advance.

  • Hello, Nikolay. To restore the disability group, the results of all examinations performed should be collected. It is necessary to take a referral to the medical examination from the attending physician; the decision of the commission, based on the results of which the disability was lifted, will also be useful. Having all the specified documents, you should write a letter to the bureau that conducted the last examination (or directly to the main ITU bureau). It is important to submit your application within a month from the moment the group was removed or transferred to another. Your appeal should indicate your disagreement with the results of the ITU. No later than 3 days from the date of receipt of your letter, the ITU Bureau must send your application and necessary documents to the main office. Based on your application, a repeat ITU with a different composition should be appointed within a month. This commission can refute the decision of the previous one (i.e. leave the group) or agree that the patient is not assigned a group (or is assigned, but a different one).

Hello! I'm 39. An orphan since 33. I live alone. For a long time, my family themselves blocked me from the street, they ran after me everywhere. People laughed. From a regular school they were transferred to a boarding school for 5 years under the ZPR. Since I was 11 years old, I have been reading and singing in an Orthodox church. I have a higher library education. I studied with difficulty. They are not accepted into religious institutions. I have been to monasteries, but they say he is worldly and family-oriented in spirit. And I have a tragedy. At the age of 12 he was raped, then everyone rejected him, even in the temple. He became either a fool or a holy fool. I tried to show everyone that I was normal and looking for friends. But they only took away my pension. I'm on group 3 for life. He was released from the army in 1998 due to organic matter, but his fitness was limited. Since childhood, I have grown up cheerful, open, trusting, wanting to help people, but people avoid me. In 2008, he began drinking beer and port wine, and in 2010 he ended up in the police custody. At the same time, my mother was very sick. She died in 2011. Then she graduated from Moscow State University of Culture and Culture and began visiting monasteries. I saw that another life was still possible. He returned home, was raped again, ran away to monasteries again. Sometimes he worked. From 2015 to this day, I sometimes meet with a woman, she has a mental illness and has a child. I am very tormented with her, sometimes she comes, sometimes she doesn’t. She writes more SMS. In March 2015, our psychiatrist diagnosed me with stage 1 organic personality disorder. They immediately asked me to leave work. The girl also turned away, and I still have innate sexual arousal, it is often required, I often masturbate. I want to look for another, but the church ministers either approve it or forbid it, they don’t trust that the family will work out and again persuade me to go to the monastery. But I already know myself that the regimes of monasteries are beyond my strength and, I noticed, in a new place, my lustful passion intensifies. There is no time for prayers or a monastery there anymore. What should I do? Now I read and sing in the city church, trying to find a friend in faith, but they are somehow detached, and I am cheerful. Even my father sees me as a child, which scares everyone away, that I am immature. But in my heart I’ve been ready for anything for a long time, but you can’t prove it to people. I need a family and that everything be mutual, based on faith and love. I tried to search on sites, but there they are looking for women with financial support, they don’t need someone like me. What should I do?

Hello, can you please tell me if a diagnosis of organic personality disorder can be made into a group, the organic disorder arose against the background of epilepsy, and an MRI also revealed a cerebrospinal fluid cyst in the brain.

my son is 22 years old. Until 2009, he was observed by a psychiatrist and graduated from school. vocational school, served in the missile forces. Now I’ve decided to get a job in the police, I passed the entire medical examination, everything is fine everywhere. But in the regional psychiatric hospital, the psychiatrist wrote a diagnosis of “organic personality disorder” and that he was observed until 2009. the doctor did not examine him, the nurse simply issued a certificate with this diagnosis. Is the diagnosis final and lifelong? Is it possible to get a job in the police? thanks in advance. Sincerely, Balatskaya Irina Viktorovna.

Hello！We are from Kazakhstan. Almaty city. My brother is diagnosed with organic personality disorder. We don’t know what to do... when he drinks alcohol he attacks everyone. We are afraid. Once they did something on his head when he was using drugs... or they drilled his head, like they wanted to drown out the nerve so that he would not use drugs... in general, this is the first time we are faced with such a situation. Tell me what to do? Is it curable?

  • Hello, Erkegali. You need to convince your brother to seek help from a psychotherapist. The family, for its part, must provide psychological support and believe in the patient’s recovery.

When passing a commission at the military registration and enlistment office, the psychotherapist makes a diagnosis after 1 visit, graduated from school, college, received a diploma, license, has never been seen by a psychotherapist, has never been registered anywhere, an athlete, has medals, certificates, cups. Is this a way to extract money from parents to pay at the military registration and enlistment office, or what! It's just some kind of nonsense. What to do, where to run to save the guy, a stigma for life, none of the syndromes.

  • Hello, Elena.
    We recommend that you appeal the diagnosis decision and suspend the implementation of this decision. To do this, you need to file a complaint, first of all, against the decision of the draft commission. If you do not agree with the conclusion of the expert doctors, you must indicate your complaints in a complaint against the decision of the draft commission.
    A statement (complaint) of disagreement with the decision of the draft commission is drawn up addressed to the chairman of the subject's draft commission.
    The following information must be provided: full name, date of birth, registration address; the approximate date of the medical examination and the meeting of the draft commission, claims and demands.
    In your complaint, demand: to cancel the decision of the draft commission on the psychiatrist’s diagnosis and conduct a control medical examination of your son.

I was raped at age 5. When I began to realize what had happened, everything collapsed. At 12 I started breathing gasoline and glue (up to 18), and at 13 I was already injecting drugs. B 24 psychotropics (screw). Before age 17, 2 suicide attempts. The colony began at 18. They wrote in the direction of F 18-26. Officially I have 117 B with the mark of limited capacity. Constant feeling of doom, unwillingness to live, social inadaptability. But you can't tell from the outside. Inexplicable bouts of crying (muffled - just tears, hopelessness). Problems with the opposite sex. I'm 35 and I don't want to live anymore. It's in my head and I can't fight it. I turn to drugs, but I only make the situation worse.

  • Hello, Artem. We sympathize with your problem. It is necessary to seek and seek help from drug rehabilitation centers and social rehabilitation centers; volunteer centers and charitable foundations dealing with the problem of drug addiction treatment. This will allow you to return to a full life, adapt and self-realize in society.
    Treatment in such places is anonymous, all information will be known only to you and the treating doctors (psychotherapist, narcologist, clinical psychologist, addiction consultant), so all sensitive information received from you will be kept secret.

I was in college and got beaten up badly. Before college, I had head injuries, and as a result of the injuries, I went to work in a restaurant and drank heavily. Now I’m 35 years old - no profession, no memory, no intelligence, I live with my parents, I’m not attracted to the opposite sex. I’ve been taking antidepressants for five years, Velaxin, nootropics, cerebralysin, and on an MRI I have a Verge’s cyst and septum pellucidum, but they write a development option. I hardly believe it, I think that they are acquired cysts. The doctors said it was chronic. I said a lot that I drank heavily. A new, young doctor came, he didn’t like me because he drank, he didn’t pay attention to the injuries that he had. For me, they pay you money for the group just like that, and he doesn’t take into account the fact that I can’t work. I had problems - I was attracted to my own gender (paraphilias), I told them this, they did not like me. I told the new young doctor today that I feel drawn to my own sex and want to sit next to him and cry. He actually hated me today, well, this is not normal - this is also a disease, not only is he not attracted to the opposite sex, for more than ten years now I have wanted to cry and hug him with my own sex. Thirdly, I have a correspondence diploma from the Institute of Culture and Retraining as a manager-economist, but I can’t cope with it. When I don’t take antidepressants, I don’t even have any cognitive interest, I lie flat on the EEG, I used to be petite, now the cortical rhythm is disorganized. I went to the capital and raised the issue of stem cell treatment, but these locals didn’t like it at all. The diagnosis says organic personality disorder with moderate cognitive impairment of a mixed type, and convulsive syndrome, but the EEG has not shown petit mal for a long time, only disorganization of the cortical rhythm. I couldn’t sleep without chlorprotexene for six months, I thought they would admit me to make the diagnosis worse, but they say that they only gave me a third one for a year. So that at least the third one is not removed.

My nephew is 5 years old, given a disability, diagnosed with organic personality disorder, psycho-speech delay - CAN A CHILD ATTEND A PRESENTER? OR WHERE SHOULD I GO FOR A CHILD TO ATTEND THE OU? I went to kindergarten, but I have problems, they say he fights, hits children, etc.

  • Hello Bairma. The Department of Education needs to find out what documents need to be collected, where to pass the commission in order to place a child in a correctional group of a kindergarten, taking into account his diagnosis.

Hello. I was diagnosed with an organic disorder at the age of 12! I'm 19 years old right now. Right now, with this conclusion, I can’t go to serve in the army, I won’t get it! And you won’t be able to get a normal job!!! What do I need to do to get this conclusion removed from me!? And in general, is it possible to remove such a conclusion from oneself or not?

  • Hello, Vladislav. You need to contact the PND and write an application addressed to the chief physician, in which you state in free form a request for a repeat psychiatric examination for possible removal of the psychiatric diagnosis. If the examination results allow, your diagnosis will be removed.

Please tell me, I have a 7-year-old child, she started drawing with feces in the toilet and smearing it under the carpet, so she made an appointment with a psychologist. Will she help?
Or straight away to a psychiatrist with such a problem?

  • Hello Anna. You did everything right. Based on the results of the examination of the child and the results of a face-to-face conversation with you, the child psychologist will make assumptions about the psychogenic nature (the presence of stressful situations) or the organic nature (due to intracerebral organic processes) of these behavioral disorders. And based on the results of the consultation, the specialist, if he deems it necessary, will recommend visiting a pediatric psychoneurologist.

Hello! Tell me please! My husband’s brother has this diagnosis. The wife's mother claims that this is a consequence of birth trauma. Also, there is a diagnosis of PEP, and a lag in physical performance. At the age of 9, the boy’s development barely reaches the parameters of a 5-year-old child. I'm pregnant - can this disease be inherited? And should I be afraid for my baby? From his first marriage there are two healthy children.

  • Hello, Olga. Considering your position, you absolutely cannot be nervous. Follow all recommendations of the doctor you are seeing during pregnancy.
    As for the diagnoses of organic personality disorder and perinatal encephalopathy, their occurrence is associated with numerous reasons, which also include persistent character anomalies, consisting of a combination of genetic and acquired properties.

Hello, I have been “sick” of this since childhood - at that age (from 4 years old) I was whiny, wore fake “smiles”, then it grew on me, and in subsequent companies I was a buffoon. I experienced a lot of dramas, in kindergarten a brick fell on my head, then it constantly fell somewhere, or in psychosis I hit my head against the walls. In short, my life was very emotional, diverse, and I played many “roles” - all this resulted in complete self-isolation, I lay at home for a year and a half in the deepest depressive psychosis after my “friends” betrayed me and my “girlfriend” left. I have been going to psychiatrists for as long as I can remember. At the age of 16 there was an excited type of illness. Now apathy is progressing. I want to get creative. Found a girl. But I don’t stay long at work; I’ve changed about a dozen in a couple of years. I want to - but I know the outcome, at first everything is smooth - and then I am a slave. First I lock myself in the back room and cry, and then I hit people in the face and send my bosses to hell. He drank a lot - every day, a lot of drugs. Quit it - 2 years clean. Sober psychoses even bring some satisfaction. I’ll ask a direct question, please answer - is it possible to diagnose a disability without going to a dispensary? I know that this is chronic, and I don’t see the point in wasting time on something that won’t bring any results (if only temporary - and if you take pills, you need money that you don’t have). Thank you for your attention. Somehow I went too far with the volume of the message - the point is disability and at least some means for your life. I'm 22.

  • Hello, Ivan. You need to contact your psychiatrist with your complaints about ill health and your desire to get a disability, who will tell you how best to act in your situation.

Good afternoon, I have this story:
I was kicked out of school in 3rd grade for truancy and poor performance. After which there was a commission and it was decided to send me to a boarding school of type 8 (for the mentally retarded), I studied there for 6 years and graduated after the ninth. (I was diagnosed with mental retardation)
When I passed the commission at the military registration and enlistment office, I was sent for additional examination. Passed a series of tests and questions.
In general, other doctors removed this diagnosis from me and gave me another one.
They didn’t take me into the army, when I asked what they gave me, they said “Organic disorder.” He asked: “What does this mean?” They said: “Nothing - live as you lived.”
I read in the comments that this diagnosis includes a disability? Why didn't they give it to me? I've never heard of her at all.
I read the entire article about this diagnosis. Well, this diagnosis doesn’t apply to me at all, the only thing I had was a concussion, I hit my head on the ice, I didn’t lose consciousness, I spent 10 days in the hospital and came out. Could this be the reason for the diagnosis?

  • Good afternoon, Igor. Traumatic brain injury (concussion) could serve as the onset of the disease and the diagnosis. If you disagree with your diagnosis, you can contact the head physician of the medical institution to prescribe additional tests. To do this, you should contact him in writing, in the form of a statement in which you justify your right and requirement to conduct examinations and research from other doctors.

My daughter was diagnosed with this at the age of 8. They only allowed home-based education, but you need a certificate from a neurologist, but it doesn’t diagnose anything, and the 9th City Police Department in Moscow said that examinations are not carried out in the country. They did not give an extract and there is no diagnosis. Now I’m 16 years old: there’s no talk of school at all. Where to go next with this kind of medicine? Tell. Her relatives can’t stand her, so she and I are homeless.

  • Marina, seek help with your problem from other doctors. One, the other will refuse, and the third will help. This could be a neuropsychiatrist, a psychiatrist, or a psychotherapist who will diagnose and prescribe the necessary treatment. Don't give up and everything will work out for you.