DOCSLIB.ORG

Acute Behaviour Disturbances

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Acute Behaviour Disturbances J7ournal ofNeurology, Neurosurgery, and Psychiatry 1993;56: 1149-1156 1149 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.56.11.1149 on 1 November 1993. Downloaded from NEUROLOGICAL EMERGENCY Acute behaviour disturbances GG Lloyd Psychiatric disorders are commonly encoun- Affective disorders tered in neurological practice and most neu- The fundamental disturbance is a change of rologists accept the need to assess and mood (or affect), either depression or elation. manage behavioural problems. The more However, mood disturbance is not necessarily complicated cases require expert psychiatric the most prominent symptom and it may be intervention and, for optimum care, it is masked by a wide range of other abnormali- essential that there is close collaboration ties which at first sight suggest the presence of between neurologist and psychiatrist. organic disease. Affective disorders have a Many neurological conditions, particularly tendency to recur. When the recurrences those with cerebral involvement, increase the always take the same form, the condition is risk of developing a psychiatric disorder. referred to as unipolar affective disorder; Furthermore psychiatric disorders can be when the mood change varies between associated with symptoms such as headache, depression or elation it is described as bipolar dizziness and weakness which suggest neuro- affective disorder. logical disease but for which no organic explanation can be found. This phenomenon, DEPRESSIVE DISORDER known as somatisation, is being increasingly Depression not associated with organic dis- recognised and accounts for a substantial pro- ease usually presents to the neurologist with portion of patients who are referred to neuro- symptoms such as headache, dizziness, dis- logical departments. turbance of higher mental function and facial Schiffer' evaluated a consecutive series of or bodily pain.4 Psychological symptoms, 241 patients attending an American neurol- emotional conflicts, and life stresses may not ogy service and found that 101 (41.9%) had be volunteered and are only elicited by tact- symptoms sufficient to warrant a psychiatric ful, direct questioning on the part of the diagnosis according to DSM-III criteria. Of examining doctor. Fitzpatrick and Hopkins5 57 inpatients, 10 were considered to have a assessed a series of patients referred to a neu- primary psychiatric disorder and five of these rologist with headaches not due to structural http://jnnp.bmj.com/ had no neurological illness. Among 184 out- disease and found that 37% had an affective patients, 32 had a primary psychiatric disor- disorder of at least mild severity. The preoc- der and 30 of these had no neurological cupation with pain may dominate the clinical illness. Kirk and Saunders2 had previously picture to such an extent that the patient does described a retrospective survey from a neu- not appear depressed and does not readily rological clinic in northeast England and admit to feeling depressed. This has been reported that, during a four year period, 358 described in relation to facial pain6; the cogni- (13-2%) of 2716 patients had a psychiatric tive features of depression such as self on September 28, 2021 by guest. Protected copyright. disorder with no evidence of neurological ill- reproach, suicidal thinking and psychomotor ness. retardation were uncommon but, in addition If the psychiatric disorder underlying the to pain, the patients complained of insomnia, neurological symptoms is not recognised, fatigue, irritability, and agitation. patients can be subjected to unnecessary and Depression also complicates existing neu- expensive investigations3. They may receive rological disease. In some cases-for exam- symptomatic treatment which fails to alleviate ple, spinal cord injuries,78 depression appears their condition and they will become dissatis- to result largely from the personal and social fied with the result of their treatment and try implications of the neurological disability. to consult other specialists in the hope of In diseases in which there is cerebral in- finding a more effective remedy. volvement, the aetiology of depression is Some of the psychological symptoms and more complex. The mood disturbance may behavioural disturbances which the neurolo- be triggered by the emotional impact of the Department of gist encounters are of sudden onset and disease but may also result from structural Psychiatry, Royal require urgent attention. This review pathology, possibly through interference Free Hospital, describes the clinical features and manage- with neurotransmitter pathways within the London, UK G GLloyd ment of those disorders which are most likely brain. Depressive disorders with cerebral in- Correspondence to: to give rise to acute behavioural problems in volvement are classified as the organic mood Dr Uloyd neurological practice. disorders by the International Classification 1150 Lloyd J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.56.11.1149 on 1 November 1993. Downloaded from of Disease (ICD-10).9 One of the most signif- should evaluate the patient as soon as icant features of these disorders is that the possible. A number of management options, mood disturbance, either depression or including outpatient or day hospital treat- mania, may be the first manifestation of ment, are available according to the perceived underlying neurological pathology. 10 risk and availability of social support. When Suspicion of unrecognised physical illness the risk is high and the patient has little in the should be particularly high if there is no clear way of support, admission to a psychiatric psychosocial precipitant, if the mood disorder ward should be advised; this may have to first presents in middle or late life and if there involve invoking the Mental Health Act if the is no family or personal disposition to psychi- patient cannot be persuaded to accept volun- atric illness." tary admission. Depression has been described as a presenting feature of cerebral tumours,12 Stupor multiple sclerosis,"3 14 Parkinson's disease'5 16 Stupor is another serious complication of and Huntington's chorea17 18 but most atten- depression. It is a term that leads to disagree- tion has been given to its association with ment between neurologists and psychiatrists, cerebrovascular disease. Eastwood et al 19 re- who use it in different ways. It is sometimes ported that 10% of patients in a stroke reha- used to describe an intermediate stage on the bilitation inpatient unit had a major spectrum of impaired consciousness that depressive disorder, while 40% had symp- eventually leads to coma. Lishman29 argues toms of minor depression. Robinson et al 20 that this is an incorrect use of the concept studied patients admitted to hospital after an which he believes is more appropriately acute stroke and found that 27% demon- defined as a syndrome in which the patient is strated symptoms of major depression, while conscious but makes no spontaneous move- 20% had symptoms of minor depression. The ment and shows little response to external association between mood disturbance and stimuli; in the most advanced form of stupor severity of physical impairment is not a strong the patient is completely mute and immobile. one and it has been proposed that the site of Consciousness is inferred by the fact that the vascular lesion is important in determin- there may be purposeful eye movements, fol- ing post-stroke depression. Left-sided lesions lowing the actions of other people in the in the frontal lobe or basal ganglia have been vicinity, and also by the patient's recall of particularly implicated.2' Other reports have events once recovery has occurred. In psychi- not confirmed this hypothesis and have found atric practice, depression and schizophrenia a lower prevalence of depressive illness, espe- are the commonest causes of stupor.30"3 The cially when the survey has included patients diagnosis depends on eliciting a history of the not admitted to hospital.22 relevant symptoms during the weeks before Some patients with cerebrovascular disease the onset of stupor. In the case of depression experience mood disturbances that are too there is a history of progressive psychomotor brief to justify the diagnosis of a depressive retardation in addition to the psychological illness.2' This phenomenon, known as patho- symptoms of low mood, guilt and self logical emotionalism, is manifest by rapid reproach. A full neurological evaluation, in- changes of mood, sudden episodes of crying, cluding CT of the brain, is essential before a can be made with and inappropriate and uncontrollable laugh- diagnosis confidence. http://jnnp.bmj.com/ ter. This type of mood change has been Cerebral disorders that can give rise to the observed more commonly in patients with clinical picture of stupor include dementia, lesions in the left frontal and temporal areas. encephalitis, and cerebral tumour or cyst in the upper midbrain or posterior diencephalon Assessment ofsuicide risk causing increased intracranial pressure. The risk of suicide is one of the reasons why depression can become an acute medical Management ofdepressive disorder problem and it must be considered when Depression usually responds to a combined on September 28, 2021 by guest. Protected copyright. assessing any patient who is thought to be approach of antidepressant medication and depressed. The risk is increased in several cognitive therapy. Tricyclic antidepressants neurological disorders,2425 particularly multi- (amitriptyline,
Load more

Recommended publications
  • Psychogenic and Organic Amnesia. a Multidimensional Assessment of Clinical, Neuroradiological, Neuropsychological and Psychopathological Features
    Behavioural Neurology 18 (2007) 53–64 53 IOS Press Psychogenic and organic amnesia. A multidimensional assessment of clinical, neuroradiological, neuropsychological and psychopathological features Laura Serraa,∗, Lucia Faddaa,b, Ivana Buccionea, Carlo Caltagironea,b and Giovanni A. Carlesimoa,b aFondazione IRCCS Santa Lucia, Roma, Italy bClinica Neurologica, Universita` Tor Vergata, Roma, Italy Abstract. Psychogenic amnesia is a complex disorder characterised by a wide variety of symptoms. Consequently, in a number of cases it is difficult distinguish it from organic memory impairment. The present study reports a new case of global psychogenic amnesia compared with two patients with amnesia underlain by organic brain damage. Our aim was to identify features useful for distinguishing between psychogenic and organic forms of memory impairment. The findings show the usefulness of a multidimensional evaluation of clinical, neuroradiological, neuropsychological and psychopathological aspects, to provide convergent findings useful for differentiating the two forms of memory disorder. Keywords: Amnesia, psychogenic origin, organic origin 1. Introduction ness of the self – and a period of wandering. According to Kopelman [33], there are three main predisposing Psychogenic or dissociative amnesia (DSM-IV- factors for global psychogenic amnesia: i) a history of TR) [1] is a clinical syndrome characterised by a mem- transient, organic amnesia due to epilepsy [52], head ory disorder of nonorganic origin. Following Kopel- injury [4] or alcoholic blackouts [20]; ii) a history of man [31,33], psychogenic amnesia can either be sit- psychiatric disorders such as depressed mood, and iii) uation specific or global. Situation specific amnesia a severe precipitating stress, such as marital or emo- refers to memory loss for a particular incident or part tional discord [23], bereavement [49], financial prob- of an incident and can arise in a variety of circum- lems [23] or war [21,48].
    [Show full text]
  • Express Feelings Result in Conflict. Love Is the First Felt. Emotion. The
    DO (1IIMR NT RP!SIIMPI 1 ED 030 161 . 24 CG 004 202 By -Ciammatteo, Michael C. Emotions In Kids--Are YOc.Parrt. Of. It? Northwest Regional Educatonal Lab.; Portland, Oreg. Spons Agency-Office ofsEducatibn (E>1:1EW). Washington, D.C. Bureau of Research. Bureau No-BR-6-2871 Pub Date Mar 69 Note -25p. 4 EDRS Price MF -$0.25 .1,1C -$1.35 Descriptors -AffeCtion.*Childhood Ileeds,*ChildRearing,Children,*EmotionalAdjustment,*Emotional Development, *Parent Child Relatorihip, Personality Development Development- of a .h.eathy adult personality depends upon the healthy growth of emotions which results from the fulfillment of certain needs. Emotions are learned and are continuously developed.. Fear of emotional confrontatibn andlack of ability to express feelings result incOnflict. Love isthe firstfelt. emotion. The need for individual affection is paramount in children. It isthe. baSe upon which security, a second need. is built. Security.iMplies acceptance of. self. byethers. Another childhood and adolescent neeC! is Self-.tepect generated by receivin0 respect from others. The child needs to experience; .ackievement. to explore his environment, and to practice skills.Hisachievement will reWt inself-esteem, pride, and ambition. Histrue accomplishments require'. f.-cogniffon. He needs gradual gt7anting ..of independence. coupled with understan8.ing.. authority. Errors of child-rearing practicesinthe historical development o.f...1,h.e.:fmily in America point to the:necessity of reorientation, the focal point of which may. be, managing emotions. (AE) (31-4-1P7/ br-'15" log--2 se U.S. DEPARTMENT OF HEALTH, EDUCATION & WELFARE OFFICE OF EDUCATION THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIGINATING IT.POINTS OF VIEW OR OPINIONS STATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDUCATION POSITION OR POLICY.
    [Show full text]
  • Socio-Emotional Conflict in Teams: a Social Relationsanalysis and Explorationof Causes
    University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Doctoral Dissertations Graduate School 8-2006 Socio-Emotional Conflict in eams:T A Social Relations Analysis and Exploration of Causes Jacqueline Zelno Bergman University of Tennessee, Knoxville Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss Part of the Psychology Commons Recommended Citation Bergman, Jacqueline Zelno, "Socio-Emotional Conflict in eams:T A Social Relations Analysis and Exploration of Causes. " PhD diss., University of Tennessee, 2006. https://trace.tennessee.edu/utk_graddiss/4289 This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a dissertation written by Jacqueline Zelno Bergman entitled "Socio- Emotional Conflict in eams:T A Social Relations Analysis and Exploration of Causes." I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the equirr ements for the degree of Doctor of Philosophy, with a major in Psychology. Joan R. Rentsch, Major Professor We have read this dissertation and recommend its acceptance: Lowell Gaertner, John T. Mentzer, Michael C. Rush Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) To the Graduate Council: I am submitting herewith a dissertation written by Jacqueline Zelno.
    [Show full text]
  • PAVOL JOZEF ŠAFARIK UNIVERSITY in KOŠICE Dissociative Amnesia: a Clinical and Theoretical Reconsideration DEGREE THESIS
    PAVOL JOZEF ŠAFARIK UNIVERSITY IN KOŠICE FACULTY OF MEDICINE Dissociative amnesia: a clinical and theoretical reconsideration Paulo Alexandre Rocha Simão DEGREE THESIS Košice 2017 PAVOL JOZEF ŠAFARIK UNIVERSITY IN KOŠICE FACULTY OF MEDICINE FIRST DEPARTMENT OF PSYCHIATRY Dissociative amnesia: a clinical and theoretical reconsideration Paulo Alexandre Rocha Simão DEGREE THESIS Thesis supervisor: Mgr. MUDr. Jozef Dragašek, PhD., MHA Košice 2017 Analytical sheet Author Paulo Alexandre Rocha Simão Thesis title Dissociative amnesia: a clinical and theoretical reconsideration Language of the thesis English Type of thesis Degree thesis Number of pages 89 Academic degree M.D. University Pavol Jozef Šafárik University in Košice Faculty Faculty of Medicine Department/Institute Department of Psychiatry Study branch General Medicine Study programme General Medicine City Košice Thesis supervisor Mgr. MUDr. Jozef Dragašek, PhD., MHA Date of submission 06/2017 Date of defence 09/2017 Key words Dissociative amnesia, dissociative fugue, dissociative identity disorder Thesis title in the Disociatívna amnézia: klinické a teoretické prehodnotenie Slovak language Key words in the Disociatívna amnézia, disociatívna fuga, disociatívna porucha identity Slovak language Abstract in the English language Dissociative amnesia is a one of the most intriguing, misdiagnosed conditions in the psychiatric world. Dissociative amnesia is related to other dissociative disorders, such as dissociative identity disorder and dissociative fugue. Its clinical features are known
    [Show full text]
  • Paranoid Or Bizarre Delusions, Or Disorganized Speech and Thinking, and It Is Accompanied by Significant Social Or Occupational Dysfunction
    Personality Disturbance Gathering, nr.34 (key to possible disturbances) Every person may be used only once, and all conditions best match one character. 1. Agoraphobia – The fear of having a panic attack in a setting from which there is no easy means of escape. 2. Alcoholism – Characterized by frequent and uncontrolled consumption of alcohol despite its negative effects on the drinker's health, relationships, and social standing. 3. Anorexia –An eating disorder characterized by refusal to maintain a healthy body weight, and an obsessive fear of gaining weight due to a distorted self image. 4. Bipolar Personality Disorder – Defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes. 5. Bulimia – An eating disorder characterized by recurrent binge eating, followed by compensatory behaviors. 6. Co-Dependant Relationship – A tendency to behave in overly passive or excessively caretaking ways that negatively impact one's relationships and quality of life. It often involves putting one's own needs at a lower priority than others while being excessively preoccupied with the needs of others. 7. Cognitive Distortions / all-of-nothing thinking (Splitting) – Thinking of things in absolute terms, like "always", "every", "never", and "there is no alternative". 8. Cognitive Distortions / Mental Filter – Focusing almost exclusively on certain, usually negative or upsetting, aspects of an event while ignoring other positive aspects. 9. Cognitive Distortions / Disqualifying the Positive – Continually reemphasizing or "shooting down" positive experiences for arbitrary reasons. 10. Cognitive Disorder / Labeling and Mislabeling – Explaining behaviors or events, merely by naming them in an over-generalized manner.
    [Show full text]
  • Cognitive Disorders: a Perspective from the Neurology Clinic
    This is a repository copy of Functional (Psychogenic) Cognitive Disorders: A Perspective from the Neurology Clinic. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/93827/ Version: Accepted Version Article: Stone, J., Pal, S., Blackburn, D. et al. (3 more authors) (2015) Functional (Psychogenic) Cognitive Disorders: A Perspective from the Neurology Clinic. Journal of Alzheimer's Disease, 49 (s1). S5-S17. ISSN 1387-2877 https://doi.org/10.3233/JAD-150430 Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version - refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher’s website. Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing [email protected] including the URL of the record and the reason for the withdrawal request. [email protected] https://eprints.whiterose.ac.uk/ Functional (psychogenic) memory disorders - a perspective from the neurology clinic Jon Stone1 , Suvankar Pal1,2, Daniel Blackburn2, Markus Reuber2, Parvez Thekkumpurath1, Alan Carson1,3 1Centre for Clinical Brain Sciences, University of Edinburgh, Western General Hospital, Crewe Rd, Edinburgh EH4 2XU, UK.
    [Show full text]
  • Emotions: Understanding the Basics
    Emotions: Understanding the Basics By Fred Kofman Spring 2001 This is a translation of chapter 21, Metamanagement Volume III, Granica, 2001. The heart has reasons which reason knows not of. Pascal As a result of Daniel Goleman’s research,i emotional intelligence has become a hot subject in the business world. Lyle Spencer Jr., co-founder of one of the most important human resources consultancies (Hay Group), maintains that “what you learned in school distinguishes superior performers in only a handful of the five or six hundred jobs for which we’ve done competency studies. It’s just a threshold competence; you need it to get in the field, but it does not make you a star. It’s the emotional intelligence abilities that matter more for superior performance.”ii It’s precisely these emotional competencies that are so saliently missing from the curriculum of our traditional educational institutions. Summarizing his experience, Goleman comments that after analyzing 181 competence models from 121 organizations worldwide, he found that “67 percent – two out of three – of the abilities deemed essential for effective performance were emotional competencies. Compared to IQ and expertise, emotional competence mattered twice as much.”iii Increasing numbers of companies are discovering that emotional competencies mean competitive advantages. With the general adoption of this idea, emotional intelligence has become an essential condition for survival. Emotional intelligence is what allows the mission, vision and values of the company to be consistently put into practice amidst daily pressures. In order to respond to the dizzying, intense rhythm of changes in products, markets, prices and consumer and employee preferences, organizations need a permanent anchor in a vision, mission and values.
    [Show full text]
  • Emotional Contagion and Its Influence on Group Behavior Author(S): Sigal G
    The Ripple Effect: Emotional Contagion and Its Influence on Group Behavior Author(s): Sigal G. Barsade Source: Administrative Science Quarterly, Vol. 47, No. 4 (Dec., 2002), pp. 644-675 Published by: Sage Publications, Inc. on behalf of the Johnson Graduate School of Management, Cornell University Stable URL: http://www.jstor.org/stable/3094912 . Accessed: 12/02/2015 02:13 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. Sage Publications, Inc. and Johnson Graduate School of Management, Cornell University are collaborating with JSTOR to digitize, preserve and extend access to Administrative Science Quarterly. http://www.jstor.org This content downloaded from 128.103.149.52 on Thu, 12 Feb 2015 02:13:10 AM All use subject to JSTOR Terms and Conditions The Ripple Effect: Group emotional contagion, the transfer of moods Emotional among people in a group, and its influence on work Contagion was examined and Its Influence on group dynamics in a laboratory study of managerial decision making using multiple, convergent Group Behavior measures of mood, individual attitudes, behavior, and group-level dynamics. Using a 2 x 2 experimental design, Sigal G. Barsade with a trained confederate enacting mood conditions, the effect of emotional was found YaleUniversity predicted contagion among group members, using both outside coders' rat- ings of participants' mood and participants' self-reported mood.
    [Show full text]
  • Downloaded by [New York University] at 05:21 15 August 2016 “Jefferson A
    Downloaded by [New York University] at 05:21 15 August 2016 “Jefferson A. Singer and Karen Skerrett have done a great favor for cou- ples and couples therapists. Our whole society needs a lot less focus on ‘me’ and a lot more emphasis on ‘We.’ Perhaps the best parts of the book are the stories—the authors use illustrations from their own lives in addition to tales of couples who fi nd meaning in the relationships they create together.” —Gene Combs, MD, Associate Clinical Professor of Psychiatry, Pritzker School of Medicine, University of Chicago. Co-author of Narrative Therapy: The Social Construction of Preferred Realities and Narrative Therapy with Couples. “Positive Couple Therapy forges a creative, dynamic marriage: excellent scholarship and real-world tools. It offers an accessible, practical guide for helping couples reclaim their stories of togetherness. Beyond that, it inspires all of us to re-discover and share the precious crystals of personal memory that refl ect our deepest love; to learn how to make the subtle but daring shift to not only being me, but being ‘We.’” —Susan Bluck, PhD, University of Florida “Singer and Skerrett have written a wonderful book about working with less distressed couples that accentuates building and drawing on a sense of ‘We.’ This book artfully integrates positive psychology, narrative prac- tice, and an often ignored thread of research that unequivocally points to the value a sense of ‘We’ has in couple satisfaction and individual hap- piness. Full of wonderful life stories and case examples, Singer and Sker- Downloaded by [New York University] at 05:21 15 August 2016 rett’s book points to how couples can actively cultivate and grow their We-Stories and thus their relationships.” —Jay Lebow, PhD, ABPP, Clinical Professor, Family Institute at Northwestern University This page intentionally left blank Downloaded by [New York University] at 05:21 15 August 2016 POSITIVE COUPLE THERAPY Positive Couple Therapy: Using We-Stories to Enhance Resilience is a signifi cant step forward in the couple literature.
    [Show full text]
  • DSM-III-R Revisions in the Dissociative Disorders: an Exploration of Their Derivation and Rationale
    DSM-III-R Revisions in the Dissociative Disorders: An Exploration of their Derivation and Rationale Richard.P. Kluft, M.D. Marlene Steinberg, M.D. Robert L. Spitzer, M.D. ABSTRACT The authors describe and explore changes in the dissociative disorders included in the new DSM-III-R. The classification itself was redefined to minimize inadvertant areas of overlap with other classifications. Recent findings have necessitated substan­ tial revisions of the criteria and text for multiple personality disorder. Ganser's Syndrome, listed as a factitious disorder in DSM­ III, is reclassified on the basis of recent research as a dissociative disorder not otherwise specified. The examples for dissociative disorder not otherwise specified have been expanded to better accommodate recognized dissociative syndromes that do not fall within the four formally defined dissociative disorders. Several novel diagnostic entities and reclassifications were proposed that were rejected for DSM-III-R because there is insufficient supporting data at this point in time. These proposals identify issues that will require reconsideration for DSM-JV. The Advisory Committee on the Dissociative chronic (3). If it occurs primarily in identity, the Disorders was one of several such committees convened person's customary identity is temporarily forgotten, by the Work Group to Revise DSM -III to review the and a new identity may be assumed or imposed (as in DSM III (American Psychiatric Association, 1980) clas­ Multiple Personality Disorder), or the customary feeling sifications, criteria, and texts in the light of interim of one's own reality is lost and replaced by a feeling of clinical experience and scientific findings, and recom­ unreality (as in Depersonalization Disorder).
    [Show full text]
  • Alleged Amnesia in Sexual Crime Alexandre Martins Valença1 Alegação De Amnésia Em Crime Sexual
    BRIEF COMMUNICATION Cláudia Cristina Studart Leal1 https://orcid.org/0000-0003-1416-6127 Alleged amnesia in sexual crime Alexandre Martins Valença1 https://orcid.org/0000-0002-5744-2112 Alegação de amnésia em crime sexual DOI: 10.1590/0047-2085000000281 ABSTRACT The current article describes the case of a man who claimed amnesia in relation to a sexual crime he had allegedly committed. Psychiatric examination concluded that the individual was feigning amnesia. Claimed amnesia of a criminal offense is one of the most commonly feigned symptoms in the forensic medical setting. It is thus necessary to rule out organic or psychogenic causes of amnesia and always consider feigned amnesia in the presence of psychopathological alterations that do not reflect classi- cally known syndromes. KEYWORDS Crime, amnesia, simulation, criminal liability. RESUMO O presente artigo descreve o caso de um homem que alegou amnésia ao fato da denúncia de cri- me sexual que lhe foi imputada. A perícia psiquiátrica concluiu tratar-se de simulação. A alegação de amnésia da ofensa criminosa é um dos sintomas mais comumente simulados no ambiente pericial. Portanto, devem-se excluir as causas de amnésia orgânica ou psicogênica e sempre considerar a am- nésia simulada na presença de alterações psicopatológicas que não configuram quadros sindrômicos classicamente conhecidos. PALAVRAS-CHAVE Crime, amnésia, simulação, responsabilidade penal. Received in: Mar/13/2020. Approved in: Jun/6/2020 1 Federal University of Rio de Janeiro (UFRJ), Institute of Psychiatry (IPUB), Rio de Janeiro, RJ, Brazil. Address for correspondence: Cláudia Cristina Studart Leal. Av. Venceslau Brás, 71, Praia Vermelha – 22290-140 – Rio de Janeiro, RJ, Brazil.
    [Show full text]
  • Amnestic Syndrome Last Updated: May 8, 2019 DEFINITIONS, CLINICAL FEATURES
    AMNESIAS S6 (1) Amnestic syndrome Last updated: May 8, 2019 DEFINITIONS, CLINICAL FEATURES ........................................................................................................ 1 ANATOMINIS SUBSTRATAS ..................................................................................................................... 2 ETIOLOGY ............................................................................................................................................... 3 DIAGNOSIS ............................................................................................................................................. 3 TREATMENT ........................................................................................................................................... 5 DBS ....................................................................................................................................................... 5 AGE-ASSOCIATED MEMORY IMPAIRMENT .............................................................................................. 6 KORSAKOFF SYNDROME (S. PSYCHOSIS) ................................................................................................. 6 TRANSIENT GLOBAL AMNESIA................................................................................................................ 7 FACTITIOUS (PSYCHOGENIC) AMNESIA .................................................................................................. 8 DEFINITIONS, CLINICAL FEATURES AMNESIA - syndrome with disturbance
    [Show full text]