Organic Psychosis 什麼是器質性精神病？(英文)
Organic Psychosis 什麼是器質性精神病？(英文)
What is organic psychosis?
Organic psychosis refers to temporary or permanent functional disorders of brain tissue, resulting in psychological and behavioral abnormalities, which cause disorders in personality, emotion, cognitive function, social and occupational functions.
Chronic conditions often develop gradually and fail to improve. The decline in short-term memory is the main problem, which is commonly referred to as dementia. Acute condition is characterized by disturbance of consciousness and attention, which is called delirium or acute confusional state. Depending on the cause, brain function can recover over time and with treatment, but it can also deteriorate and become permanent.
Organic psychosis can occur at any age, due to the following causes: metabolic and endocrine disorders, substance abuse and withdrawal, drug poisoning, heavy metals, pesticide poisoning, infection, brain injury, nervous system diseases, brain lesions, environmental factors, brain degenerative diseases, circulatory disorders, genetic factors, etc.
The symptoms of organic psychosis patients vary according to the damaged central nervous system. Delirium and dementia, which are common clinically, are explained separately.
Changes in consciousness and attention, loss of orientation, lack of concentration, possible delusions or hallucinations sometimes leading to delusions, emotional breakdown, murmuring, incoherent speech; sleep disorders, possible insomnia or daytime sleepiness, memory impairment, being unable to learn new things or remember what just happened.
The deterioration of cognitive function and personality reflects the obstacles of memory, orientation, thinking ability and emotion, thus affecting occupational or social functions. Hypomnesia is the most prominent manifestation of dementia patients. At the beginning, patients become absentminded or forgetful, and in more serious cases, even have difficulty in locating people, time and place. It is more obvious in the evening and at night, especially in a strange environment, which will make the symptoms worse.
Cognitive function (including computational, understanding, recall and general knowledge application) is also affected, and it is usually found by family members that the judgments and decisions made by patients are inappropriate.
Identify the cause of the disease and address it as a top priority
- Drug therapy
The treatment must consider the pathogenic factors. For example, because of poor cerebral blood flow, some drugs can be administered to promote cerebral blood flow, promote the metabolism of brain neurons and increase the absorption of oxygen to improve the condition.
Patients with insomnia, agitation, delusion and depression sometimes would be prescribed antipsychotics and antidepressants.
- Non-drug therapy
"Maintenance of life" will be a top priority. Regular assistance in nutrition, water and electrolyte supplementation will be required. Sleep disorders are also common, so appropriate recreational activities should be scheduled at regular times to reduce lying in bed during the day to avoid disturbing nighttime sleep.
Patients with hallucinations and disorientation need to pay special attention to their safety. Because the visual hallucination of delirium patients often causes them to become so frightened that they want to escape from the scene or even jump out of the window, so they should pay attention to the safety of the environment, as well as oral safety guarantees, and timely facts.
Patients also have difficulties dealing with external information. They can't decide their priorities and consider differences, so it's helpful to give clear information and guidance to patients. For example, "It's 5:30 p.m., you can come to dinner first." is simpler and clearer than “What time do you want to eat?”
Disorientation is a common problem in patients with dementia and environmental changes should be minimized. The environment in the hospital is strange to patients, and it is easier for them to be confused about their rooms or beds. Large and clear signs are required, or familiar objects, such as photos and blankets can be placed in their personal units. The placement of a clock or a calendar helps the patient to confirm the time.
Sometimes patients will make mistakes in person, time and place, and they should be corrected and reminded at any time to reduce their anxiety caused by the wrong sense of orientation; even given a sense of reality to explain why hospitalization is needed at present.
Living at home is ideal for people with dementia who can take care of themselves. Adult day care centers may be considered if family members are not comfortable leaving patients alone at home during the day. If their condition is serious enough, they need to live in a home for the elderly or a special care institution and be cared for by professional staff.