Pseudopsychopathy: symptoms, causes and treatment

Let's see what this neurological disorder associated with extremely disinhibited behavior is.

The human brain is a complex organ that is susceptible to damage and injury. Sometimes this damage can lead to personality alterations.

Dementia or injury to a very specific area, the prefrontal area (located in the frontal lobe), can lead to a pseudopsychopathy.. We are talking about an organic personality disorder whose name comes from the similarities it can show with psychopathy or antisocial disorder. Do you want to know more about this clinical picture? Continue reading.

The importance of the frontal lobe

In the human brain we know that there are different lobes, each with different functions. The frontal lobe is the one in charge of the executive functions.The prefrontal lobe is another even more specific area of the frontal lobe. The prefrontal lobe is another even more specific area of the frontal lobe, and is divided into three more areas: dorsolateral, medial and orbitofrontal.

Prefrontal lesions cause alterations in executive functions, working memory and working memory.The prefrontal lesions cause alterations in executive functions, working memory and prospective memory, and can lead to pseudopsychopathy.

On the other hand, depending on the lesioned area, different symptoms and syndromes appear:

Dorsolateral zone.

Its lesion implies the appearance of the disjective syndrome. This consists, roughly speaking, in a robotic behavior of the subject.

Medial zone

When damaged, pseudodepression may appear. It implies the deficit of certain functions.

Orbitofrontal area

It is associated with pseudopsychopathy. It involves the excess of certain psychological functions. We will now see in more detail what this clinical picture consists of.

Pseudopsychopathy: what causes it?

Pseudopsychopathy can originate from several causes:

• Traumatic brain injury (TBI) with extensive medial basal medial lesions.
• Injury to the orbitofrontal area of the prefrontal lobe..
• Dementia.

Symptoms

Symptoms of pseudopsychopathy are: personality and emotional disturbances, disinhibition, impulsivity, irritability, ecopraxia, euphoria, hyperkinesia, impaired social judgment, moria (e.g., unmotivated smiling), lack of emotional control, social inappropriateness, obsessions, lack of responsibility, distractibility, infantilism, infantileismdistractibility, infantilism and hyperreactivity. In addition, criminal and addictive behaviors may appear.

In other words, pseudopsychopathy is a syndrome of "excess" and, above all, disinhibition. above all of disinhibitionIt is as if the rational part of the subject were annulled, and he/she had no filters as to "what behaviors are socially appropriate".

When dementia is the cause of pseudopsychopathy, there are also two other patterns that give rise to two other alterations, as we will see below.

Personality disorders in patients with dementia

There are three fundamental patterns of personality disturbance in patients with dementia. They are as follows.

Passive - apathetic pattern

The patient appears "inert".He shows absolute indifference to his surroundings. He is not interested in anything in the environment and shows a total absence of initiative.

Disinhibited pattern - pseudopsychopathy:

The patient is unpleasant, uninhibited and rude.. He picks on others, does not follow social norms and neglects his hygiene.

This pattern appears even in people who were previously extremely polite and kind.

Celotypical - paranoid ("distrustful") pattern:

The patient becomes distrustful and paranoid. He begins to believe that his partner is unfaithful, that his family is cheating on him, that everyone is against him, that they are hiding things from him, etc.

Treatment

To treat pseudopsychopathy, there are several alternatives. Individual and family psychotherapyas well as a cognitive-behavioral approach together with pharmacological treatment may be recommended options for this type of patient.

The goal with psychotherapy will be to provide a climate of trust for the patientand a space where he/she can express his/her concerns and raise his/her difficulties. Working on the therapeutic alliance will be of vital importance.

At the pharmacological level, the following have been used neuroleptics, mood stabilizers and anticonvulsants have been used.. The results have been variable.

We must take into account that, being patients with low self-criticism, they are likely to acquire some dependence on drugs. It is therefore important to work on adherence to pharmacological treatment and the correct administration of the recommended dose.

Bibliographic references:

• Junqué, C. (1999). Neuropsychological sequelae of cranioencephalic trauma. Revista de neurología, 28(4), 423-429.
• Rosenweig, M., Breedlove, S., Watson, N. (2005). Psychobiology: an introduction to behavioral, cognitive and clinical neuroscience. Barcelona: Ariel.
• Olivera, J. (2011). Dementia and personality: a two-way street. Psychiatric Information, 204(2), 77-198.
• Quiroga, F. (2013). Common psychiatric disorders in neurological diseases. Colombian Neurological Guides of the Colombian Association of Neurology.