Unlike endogenous(arising for no apparent reason) mental disorders, organic Mental disorders are diseases for which the cause is clear to us or we can assume its presence.

Psychoorganic syndrome

Organic mental disorders are characterized by the mandatory presence of the so-called. psychoorganic syndrome(impaired emotions, memory and intelligence). The mood may be inappropriately increased or decreased, anxiety or a sad-angry mood may be observed. Affect (emotional manifestations) is characterized by lability (variability), explosiveness(explosiveness), flattening ( insufficient depth of experience). All memory processes (memorization, storage, reproduction of information) are reduced. False memories (confabulations) are observed, memory for some periods of life is completely absent (amnesia). Thinking is characterized, on the one hand, by inhibition of mental processes (torpidity), difficulty switching (rigidity), and on the other hand, by increased exhaustion. The general level of thinking decreases (concepts and ideas become impoverished), a tendency to unnecessary detail appears, and perseverations arise (“getting stuck” and constant repetition of the same thought or expression). The ability to navigate is impaired - first in the environment, and then in one’s own personality. The ability to grasp the full meaning of a situation disappears; only partial details are perceived.

Variants of the course of organic mental disorders

Organic mental disorders are acute (for example, delirium, organic hallucinosis), occurring suddenly, and chronic, starting unnoticed, flowing slowly and, most often, irreversibly (dementia, organic personality change).

The most common causes of organic brain lesions are trauma, infection, intoxication, tumors, primary degenerative processes and vascular lesions of the brain.

Psychoorganic syndrome occurs in four variants:

• asthenic (exhaustion, irritability with intact intelligence),
• explosive (explosiveness, aggression, slight memory loss),
• euphoric (elevated mood, carelessness, disinhibition of drives) and
• apathetic (apathy, decreased interest in the environment and one’s own life, marked memory loss)

These four options are sequential stages of the course of organic brain disease.

Danger to yourself and others

The social significance of the clinical picture is great. If at the asthenic stage patients can take care of themselves, and many are able to work, then with increasing severity of the disease they can first become dangerous for people around them (explosive, euphoric stage), and later for themselves (apathetic stage) due to pronounced apathy and helplessness.

Therefore, organic mental disorders require timely correction. If there is one or another option, you need to contact a psychiatrist.

All materials on the site are presented for informational purposes only, approved by certified physician Mikhail Vasiliev, diploma series 064834, in accordance with license No. LO-77-005297 dated September 17, 2012, by a certified specialist in the field of psychiatry, certificate number 0177241425770.

Description of organic disorders

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. The patient suffers from mental exhaustion and decreased mental functions. As a rule, organic personality disorders manifest themselves at an early age and make themselves felt for the rest of their lives. The nature of 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 for 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 trauma, 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 and serious problems with remembering and reproducing information, which can ultimately lead to dementia.

Similar symptoms? Call the 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 carried out, 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 (these 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, and 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 currently 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.

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. At the same time, 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 depression, 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 innocence. To do this, you need advice from a lawyer or attorney. 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, 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 medical examination 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 against the backdrop of 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 will come, sometimes she won’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 gender 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 was a buffoon in subsequent companies. 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 the 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, a psychotherapist who will diagnose and prescribe the necessary treatment. Don't give up and everything will work out for you.

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. The following types of dementia are distinguished:

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

· Secondary– hormonal, infectious, intoxicating.

Dementia grades:

Ø Mild dementia- reduced ability to remember, errors in professional and social situations that are not always noticeable to others. Impairments in intellectual activity are detected only during a 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 Moderate 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 certain 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 recognition), 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 with acetylcholine transferase 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 increased zinc content in the soil may be involved in the pathogenesis. 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.

/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, distinct etiology of cerebral disease, brain injury, 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 breadth of the spectrum of psychopathological manifestations of the conditions included in this section, the main features of these disorders fall into 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 manifestations are 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. The last group of disorders has less reason to be included 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 associated with 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 in this section, 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 the 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; F0x.xx1 - due to vascular disease of the 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 provides a general description of 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 of brain disease, usually chronic or progressive, in which a number of higher cortical functions are impaired, 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 misclassification: motivational or emotional factors, especially depression, in addition to motor retardation and general physical weakness, may be more responsible for poor performance than intellectual loss. abilities. Dementia leads to a distinct decrease in intellectual functioning and, most often, also to disruption of daily activities, such as washing, dressing, eating skills, personal hygiene, and independent physiological functions. Such reduction 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: Keep in mind: - depressive disorder (F30 - F39), which may show many of the features of 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 seriously impoverished social environment and limited ability to learn; - 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 the 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 having a family history of similar forms of dementia, a faster rate of progression and characteristic signs of 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 innominate, 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 already described, clinical signs are 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 data that could suggest that the mental state is caused by other systemic or brain diseases leading to dementia (hypothyroidism, hypercalcemia, vitamin B-12 deficiency, nicotinamide deficiency, neurosyphilis, normal pressure hydrocephalus, 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. When making a 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 due to asthma may be combined with vascular dementia (code F00.2x should be used), when cerebrovascular episodes (multi-infarct symptoms) may 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 given above should be followed, with particular 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 * Alzheimer's dementia, 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, impairment of memory and mental activity becomes obvious. 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 gradual 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. Personality characteristics are believed to be relatively intact. 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 can be combined with Alzheimer's disease (code F00. 2x), if vascular episodes occur against the background of a clinical picture and anamnesis indicating the presence 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

F01.9x 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 changes in character and social decline, followed by intellectual impairment, loss of memory, 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 compared to normal aging. With early onset 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, impaired 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). The rapid course and early onset of motor disorders may speak in favor of Creutzfeldt-Jakob disease.

F02.2х * 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: The combination of choreiform movements, dementia, and a family history of Huntington's disease is highly suggestive of this diagnosis, although sporadic cases certainly may 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. F02.4х * 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, psychoses 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

other 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 improve. 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, a decrease in the ability to reproduce past events in the reverse order of 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 a major feature of the 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 amnesic syndrome in connection with F04.4 Organic amnesic syndrome F04.5 Organic amnestic syndrome due to neurosyphilis F04.6 Organic amnesic 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 during chronic liver disease, carcinoma, or subacute bacterial endocarditis. The distinctions sometimes made between acute and subacute delirium are of little 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 medication should be included under this heading (such as acute confusion in elderly patients due to antidepressants). In this case, the drug used must also be identified by 1 MH code Class XIX, ICD-10). Diagnostic Guidelines: For a definite diagnosis, mild to severe symptoms from each of the following groups must be present: a) altered consciousness and attention (from stupefaction 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 in more severe cases in place and one’s own personality); c) psychomotor disorders (hypo- or hyperactivity and unpredictability of the transition from one state to another; increase in time; increased or decreased flow of speech; horror reactions); 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); e) 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 physical pathology underlying delirium, evidence of cerebral dysfunction (eg, abnormal EEG, usually but not always showing slowing of background activity) is also needed 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 in connection with F05.05 Delirium not associated with dementia due to neurosyphilis F05.06 Delirium not associated with dementia in connection with 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 the 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. Encephalitis and carbon monoxide poisoning are thought to be more likely to cause this syndrome than other organic causes. Diagnostic Guidelines: The general criteria suggesting an organic etiology outlined in the introduction to F06 must be met. In addition, the following must be present: a) either stupor (a decrease or complete absence of 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. Clinical symptoms similar to schizophrenia, such as fanciful delusions, hallucinations, or thought disorders, may also be present. 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 in cases where the organic cause is nonspecific or is 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 presumed to be directly attributable to a cerebral or physical disorder, the presence of which must be demonstrated independently (for example, by adequate physical and laboratory tests) 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 (coming after 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 clarify the clinical disorder, it is necessary to use 5-digit codes, in which these disorders are divided into disorders of the psychotic and non-psychotic levels, unipolar (depressive or manic) and bipolar. /F06.30/ psychotic manic disorder organic nature; /F06.31/ psychotic bipolar disorder of organic nature; /F06.32/ psychotic depressive disorder of organic nature; /F06.33/ psychotic mixed disorder of 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)