Structural-Dynamic Characteristics of Psychoorganic Syndrome in Epilepsy

Background: currently, numerous studies have focused on the qualification of cognitive impairment in organic mental disorders. One of the most common organic brain diseases leading to cognitive decline is epilepsy. Recently, there is no consensus on the psychoorganic syndrome in both foreign and domestic psychiatry, that needs for a clearer phenomenological qualification of the psychoorganic syndrome, determination of the structure of cognitive impairment with the designation of lesions of certain neurocognitive domains within the syndrome, and variants of its dynamics in epilepsy. The aim of the study: determination of clinically significant characteristics of variants of psychoorganic syndrome in patients with epilepsy. Patients and Methods: the study included 84 patients with epilepsy with psychoorganic syndrome. Research methods: clinical-psychopathological, descriptive statistics method. Results: clinical and psychopathological analysis of the examined patients revealed specific features of four variants of psychoorganic syndrome. The asthenic variant (37 patients; 44%) were disorders of cognitive functions with a predominance of attention disorders, short-term memory, as well as emotional lability, asthenic symptoms. At the same time, exhaustion, being the first and most common symptom, becomes more permanent as the disease progresses. In the explosive variant (43 patients; 51,2%) against the background of increasing cognitive impairment with damage to attention, memory, and language, thinking disorders with loss of mental flexibility and mobility; personal characteristics such as emotional tension, conflict, explosiveness and brutality came to the fore. The euphoric variant (1,2%; one patient) was characterized by persistent cognitive, emotional and volitional disorders with a general decrease in the productivity of mental activity, a change in affect with a predominance of elevated mood, a sudden transition of affect from aggression and anger to tears and helplessness. The apathetic variant (3 patients; 3,6%) included negative disorders with progressive disintegration and regression of personality, pronounced disorders of all cognitive processes, paradoxicality and inadequacy of emotional reactions. Cognitive disorders were the leading psychopathological formations in all variants of psychoorganic syndrome. Conclusion: syndromic assessment of one or the other psychopathological symptomatology in organic mental disorders at the early stages of their formation can help to take into account the entire complex of disorders implied by the concept of psychoorganic syndrome. Determining the structure of cognitive impairments with the designation of neurocognitive domains and their subdomains, emotional, volitional and personality disorders in psychoorganic syndrome, as well as identifying variants of its dynamics will allow for a more accurate diagnosis of exogenous-organic pathology and outlining the main paths of treatment and rehabilitation of this category of patients.

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