Pseudopsychopathy: symptoms, causes and treatment

The human brain is a complex organ that can be damaged and injured. Sometimes this damage can cause personality disorders.

Dementia or injury to a very specific area, the prefrontal area (located in the frontal lobe), can cause pseudopsychopathy. There is talk of an organic personality disorder, the name of which arose from the similarities it may show with psychopathy or antisocial disorder. Want to know more about this clinical picture? Keep 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 responsible for executive functions, Planning and decision making. The prefrontal lobe is another even more specific area of ​​the frontal lobe, and is divided into three other areas: dorsolateral, medial and orbitofrontal.

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

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

    Dorsolateral area

    His injury involves the onset of dysexecutive syndrome. Basically, this is robotic behavior of the subject.

    Medial zone

    When damaged, pseudodepression can appear. This leads to the deficit of certain functions.

    Orbitofrontal zone

    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 are the causes?

    Pseudopsychopathy can be caused by several causes:

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

    symptoms

    Symptoms of pseudopsychopathy include: personality and emotional disturbances, disinhibition, impulsivity, irritability, ecopraxia, euphoria, hyperkinesia, impaired social judgment, death (eg, unmotivated smile), lack of emotional control, social inadequacy, obsessions, lack of responsibility, Distractibility, infantilism and hyperreactivity. In addition, criminal and addictive behavior can appear.

    In other words, pseudopsychopathy is a syndrome of “excess” and especially disinhibition, As if the rational part of the subject was overruled and the subject had no filters as to “what behaviors are socially appropriate”.

    When dementia is the root cause of pseudopsychopathy, there are also two other patterns that cause two other disorders, as we will see below.

    Personality disorders in patients with dementia

    There are three basic models of personality disorder in patients with dementia. They are as follows.

    Passive-apathetic model

    The patient seems “inert”, Shows absolute indifference to those around him. He is not interested in anything in the environment and shows a total lack of initiative.

    Uninhibited pattern: pseudopsychopathy:

    the patient he is disagreeable, uninhibited and rude. He disturbs others, does not follow social norms and neglects his hygiene.

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

    Celotypic – paranoid (“suspicious”) motif:

    the patient he becomes suspicious and paranoid. He begins to believe that his partner is unfaithful to him, that his family wants to cheat on him, that everyone is against him, that things are hidden from him, etc.

    treatment

    To treat pseudopsychopathy, there are several alternatives. Individual and family psychotherapyIn addition to a cognitive-behavioral approach combined with pharmacological treatment, they may be recommended options for these patients.

    The goal of psychotherapy will be create a climate of trust for the patient, And a space where you can express your concerns and raise your difficulties. Working on the therapeutic alliance will be vital.

    Pharmacologically, they have been used neuroleptics, mood stabilizers and anticonvulsants. The results have been mixed.

    We must keep in mind that being patients with little self-criticism, they are susceptible to developing some dependence on drugs. This is why it is important to work on compliance with pharmacological treatment and the correct administration of the recommended dose.

    Bibliographical references:

    • Junqué, C. (1999). Neuropsychological sequelae of cranioencephalic trauma. Journal of Neurology, 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 round trip. Psychiatric Information, 204 (2), 77-198.
    • Quiroga, F. (2013). Psychiatric disorders common in neurological diseases. Colombian Neurological Guides from the Colombian Neurological Association.

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