Page 1 of 1: psychiatry: dementia

gongu · Credits: 4822 My Scrapbook

dementia is seen in all except-
1.schizophrenia
2.head injury
3.huntingtons chorea
4.frontal lobe tumur.
plz help

parin · Credits: 14680 My Scrapbook My Reading List 1 Books

Gongu, I really want to thank you for posting this simple looking question..

On first look, I simply thought Schizophrenia was the answer.. But I was surprised to check the list in Harrison's & found schizophrenia in the list!!

Also it says that neoplasms in frontal & temporal lobes can cause dementia..

Head injury & Huntington's are definitely the causes of dementioa..

So?? All are the causes of dementia if we go by Harrison's..

But this is what Niraj Ahuja says in definition of dementia: it is a chronic ORGANIC mental disorder...

& it does not mention any psychiatric disroder mentioned in Harrison's (depression, schizophrenia & conversion) as a cause of dementia..

Also, I think what is seen in these conditions is amnesia, can't be called dementia.. of course, pseudo-dementia in depression...

Also Harrison's itself says.. Psychiatric diseases may mimic dementia.. shcizophrenia is usually not difficult to distinguish from dementia.. it is associated with intact memory.. event-specific AMNESIA may also develop sometimes in association with schizophrenia..

These lines point towards the answer as schizophrenia..

Only confusion lines in Harrison's are: some chronic schizophrenics develop an unexplained progressive dementia late in life that is not associated with Alzheimer's...

But I'd still go with schizophrenia..

cingulate_gyrus2006 · Credits: 22840 My Scrapbook

But parin Shizoprenia its self is called as Dementia precox(Dementia before old age) ithink...
As said in Ahooja

parin · Credits: 14680 My Scrapbook My Reading List 1 Books

Of course, cingulate gyrus!! I was almost waiting for this question & I think I have satisfactory explaination.. But we must confirm this from others too.. Read this..

Ahuja says: Emil Kraepelin recognized characteristic features -delusions, hallucinations, disturbances of affect & motor disturbances... The emphasis in diagnosis of dementia praecox was on an early onset & a ppor outcome - dementia: deterioration precox: early onset...

Let me give some information from Abnormal Psychology by Holmes:

When Kraepelin labeled dementia praecox, praecox referred to early onset & dementia to progressive deterioration.. (which is not the meaning of dementia now..)

Whne the term was introduces, it was thought that the patients suffered from an warly onset of the type of intellectual deterioration that underlies senility.. It was later realized that the deterioration in schizophrenia is very different from that in senility, & consequently the impaired intellectual functioning seen in schizophrenia is now referred to as the schizophrenic deficit in order to distinguish it from other forms of intellectual impairment...

This book also defines dementia as an organically caused loss of intellectual abilities that is great enough to interfere with social & occupational functioning..

Let me say something from Clinical Psychiatry by Mayer-Gross Slater & Roth:

In the pre-Kreapelin era, secondary dementia was considered the outcome schizophrenia.. Kraepelin spoke of different types of schizophrenia but himself pointed out that the deficiency was more in the field of emotion & volition, less in that of judgement or memory... If the term 'dementia' is used as 'impairment of intelligence', schizophrenia does not lead to dementia.. Dementia of this kind is seen in organic brain diseases...In this sense schizophrenics are not demented. Their formal intelligence is preserved as their knowledge. It is justifiable to regard the apparent dementia as the outcome of the deterioration of the patient's personality.. The fact is, advanced schizophrenic cannot make adequate use of his intelligence because of his thought disorder & volitional, catatonic & delusional disturbances and for these reasons alone. His intelligence may seem to have shrunk through lack of use, but this is a mere appearance caused by the fact that his mental activities have been narrowed down & have become fixed & rigid..

& of course we know that in fact, schizophrenics are more intelligent ones!!

In the same book, dementia is defined as
a global deterioration of mental functioning in its intellectual, emotional & cognitive aspects.. Intellectual decline is the central feature (which is not seen in schizo).. But dementia should not be used to describe personality changes...

I think this is enough to make me believe that Kraepelin used the term dementia praecox in different meaning than the term dementia is used now..

Some psychiatrist may enlighten us for more precision!!!

cingulate_gyrus2006 · Credits: 22840 My Scrapbook

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