Organic psychosyndrome

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The organic psychosyndrome ( OPS ), also organic brain psychosyndrome ( HOPS ) is a collective term for neuropsychiatric disorders resulting from an organic brain change, the cause of which can be obvious (e.g. shocks (trauma) , stroke, tumor) or subtle (e.g. inflammatory, autoimmune) . Acute and chronic forms occur. The causes are often calcifications of the cerebral vessels, accidents with head injuries, brain tumors, but also systemic diseases with brain involvement. Psychological symptoms as a result of an organic brain psychosyndrome do not represent a mental illness in the strict sense.

Classification according to ICD-10
F07 Personality and behavioral disorder due to an illness, damage, or dysfunction of the brain
F07.2 Organic psychosyndrome after head trauma
F07.9 Unspecified organic personality and behavioral disorder due to an illness, damage or dysfunction of the brain - organic psychosyndrome
ICD-10 online (WHO version 2019)

Acute organic psychosyndromes

An acute organic brain psychosyndrome can have various causes. Regardless of the mechanism causing the damage, the organic brain psychosyndrome always involves the dysfunction of brain activities due to damage on a macroscopic level (damage to the brain) or due to subtle effects ( noxae , inflammation , metabolic derangements, etc.). Common symptoms of an acute organic brain psychosyndrome include:

Depending on the cause, organic cerebral psychosyndromes are reversible or turn into chronic forms.

Chronic organic psychological syndromes

Chronic forms are - depending on the cause - stable or progressive . Examples include:

Post-inflammatory brain syndrome (PIBS)

The post-inflammatory brain syndrome (PIBS) ' Post-inflammatory brain syndrome ' is the name for an organic brain syndrome with neuropsychiatric symptoms that is associated with a chronic activation of the type 1 immune system (inert immune system). It can be the result of trauma (force exerted on the head such as a concussion ), but - with the appropriate genetic predisposition - it can also be triggered by activation of the type 1 immune response in peripheral regions of the body. The symptoms of PIBS are often diffuse; cognitive impairments of variable severity as well as motor and / or psychiatric symptoms are usually found. PIBS was first defined by a research team led by Michel P. Rathbone and describes a fundamental pathomechanism with regard to immunologically induced neuropsychiatric brain diseases. The definition of PIBS is consistent with other diseases that have been newly researched in recent years, such as anti-NMDA receptor encephalitis , anti-GABA receptor encephalitis , VGKC complex antibody encephalitis , disorders of the kynurenine metabolism as well as the Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and related diseases. Essentially, PIBS describes a complex and chronic brain syndrome of immunological origin that a. can occur as a result of minor brain injuries (e.g. bumps) and inflammatory diseases in other parts of the body (e.g. in the liver). In addition to changes in the kynurenine metabolism , cytokine releases and an activation of inflammation mediators , which can lead to disorders of brain activity, are described as essential . An effect on the signal transmission in the synaptic gap plays a prominent role here. Within the scope of the ICD-10 , PIBS is usually to be coded under F06.9 ("unspecified organic mental disorder due to damage or functional disorder of the brain or a physical illness including: organic brain syndrome onA") if the cause is unclear.

causes

The organic brain psychosyndrome can be triggered by many types of effects on the brain. The following are examples:

treatment

The treatment of an organic brain syndrome is always based on its cause. Therefore, the prognosis is also dependent on the cause. The faster and more effectively the factor causing the brain damage is eliminated, the better the chance of recovery.

See also

Individual evidence

  1. ↑ Q. Gong, L. Li, M. Du, W. Pettersson-Yeo, N. Crossley, X. Yang et al .: Quantitative prediction of individual psychopathology in trauma survivors using resting-state fMRI. In: Neuropsychopharmacology . 39 (3), 2013, pp. 681-687.
  2. ↑ Brigitte Vetter: Psychiatry: a systematic textbook. With 34 tables. Schattauer Verlag, Stuttgart 2007.
  3. ^ Brigitte Vetter: Psychiatry. A systematic textbook. Schattauer, Stuttgart 2007.
  4. ↑ Josep Dalmau, E. Lancaster, E. Martinez-Hernandez, MR Rosenfeld, R. Balice-Gordon: Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. In: The Lancet Neurology . Volume 10, Number 1, January 2011, pp. 63-74.
  5. ^ Paul H. Patterso: Infectious Behavior: Brain-Immune Connections in Autism, Schizophrenia, and Depression. 1st edition. The MIT Press, 2013, ISBN 978-0-262-52534-3 .
  6. ↑ Charlotte D'Mello, Mark G. Swain: Liver-brain inflammation axis. In: Am J Physiol Gastrointest Liver Physiol. Volume 301, 2011, pp. G749-G761. doi: 10.1152 / ajpgi.00184.2011 .
  7. ↑ B. Leonard, M. Maes: Mechanistic explanations how cell-mediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression. In: Neurosci. Biobehav. Rev. Volume 36, No. 2, 2012, pp. 764-785. doi: 10.1016 / j.neubiorev.2011.12.005 .
  8. ↑ N. Müller: The role of anti-inflammatory treatment in psychiatric disorders. In: Psychiatr. Danub. Volume 25, No. 3, 2013, pp. 292-298.
  9. ↑ E. Lloyd, K. Somera-Molina, LJ Van Eldik, DM Watterson, MS Wainwright: Suppression of acute proinflammatory cytokine and chemokine upregulation by post-injury administration of a novel small molecule improves long-term neurologic outcome in a mouse model of traumatic brain injury. In: J. Neuroinflammation. Volume 5, No. 1, 2008, p. 28. doi: 10.1186 / 1742-2094-5-28 .
  10. ^ AT Rathbone, S. Tharmaradinam, S. Jiang, M. Rathbone, DA Kumbhare: A review of the neuro- and systemic inflammatory responses in post concussion symptoms. Introduction of the "post-inflammatory brain syndrome" PIBS. In: Brain, Behavior, and Immunity. Volume 46, 2015, pp. 1–16. doi: 10.1016 / j.bbi.2015.02.009 .
  11. ↑ Gerd Huber: Psychiatry. Textbook for study and further education. 7th edition. Schattauer, Stuttgart 2005.