Organic emotionally labile disorder. J06.8 Other acute upper respiratory tract infections of multiple localization The psychologist diagnosed a child with f 06.8

Organic emotionally labile disorder Is a mental disorder that occurs after complications of pregnancy or childbirth, severe infection or organic brain disease (trauma, tumor, stroke)... Are characteristic pronounced emotional incontinence and lability (instability, rapid change) of a person's mood.

A psychiatrist (or psychotherapist) and a neurologist should work together to diagnose and treat this disorder.

The disorder is also called asthenic (from the Greek asthenia - weakness, impotence). In addition to constant and severe mood swings, patients are characterized by general weakness , fast fatiguability, headache, dizziness... A person can get tired after 2-3 hours of work, cannot stand a full working day, several times a day it becomes necessary to lie down to rest.

According to international classification diseases ICD-10 is coded as F06.68 - "Organic emotionally labile asthenic disorder due to mixed diseases." To its most frequent reasons include:

• head injury
• pregnancy and mother's childbirth, which proceeded with complications (toxicosis, threat of miscarriage, eclampsia)
• serious condition of the child after birth (for example, the baby was given mechanical ventilation), serious illnesses / infections of early childhood
• vascular diseases of the brain (atherosclerosis, hypertonic disease, disorders of cerebral circulation - strokes)
• epilepsy
• brain tumors
• HIV infection
• neurosyphilis and other neuroinfections, encephalitis (inflammation in the brain)
• intoxication narcotic substances, alcohol
• consequences of anesthesia

Symptoms of organic asthenic disorder

People with the disorder are characterized by tearfulness, emotional hot temper, frequent and pronounced mood swings, a storm of emotions, often for a minor reason. All reactions are spontaneous (occur without a serious reason, reason) and uncontrollable.

A person reacts painfully even to minor events, emotions, as a rule, are negative in nature (anger, irritation, resentment).

He perceives troubles as "the end of the world", constantly outbursts of anger and irritability towards loved ones, people around him.

Diagnosis of organic emotionally labile disorder - examination by a psychiatrist and neurologist. Additionally, the attending physician may prescribe a pathopsychological study, blood tests and instrumental methods (EEG, CT, MRI).

The person complains of regular and strong headache, dizziness, decreased or impaired vision, increased blood pressure, noise in ears. These complaints are indicative of a brain disease that led to an organic, emotionally labile disorder. They prevent a person from living and working, because of them he goes to the doctor.

Hypersensitivity is characteristic - pain sensitivity in response to a weak touch on the skin, excessive auditory or photosensitivity, when sounds of ordinary strength are perceived as very loud (up to the development of pain syndrome), and sunlight causes severe lacrimation and pain in the eyes.

General weakness, rapid fatigability, decreased performance, a feeling of powerlessness - all these are integral companions of organic asthenic disorder.

Organic emotionally labile asthenic disorder in children occurs due to severe pregnancy of the mother (toxicosis, threat of miscarriage, eclampsia), complications in childbirth or severe diseases of early childhood.

An experienced psychiatrist can make a diagnosis already at the first examination. The main manifestations of asthenic disorder include excessive moodiness, frequent tearfulness, disobedience, irritability, inability to concentrate for a long time. Such children may experience sudden lethargy, lack of initiative. It is necessary to differentiate emotionally labile disorder from personality traits and age-related changes.

The prognosis in adults and children is favorable if the recommendations of the attending physician are followed.

Treatments for organic emotionally labile personality disorder

Treatment should be comprehensive and strictly individual. With the correct diagnosis and adequate treatment, the symptoms of asthenic disorder can weaken or go away completely.

Organic emotionally labile asthenic disorder is treated with medication and non-medication. The following groups of pharmaceuticals are classified as medications:

• vaso-vegetotropic - normalize the work of the autonomic nervous system
• nootropics - improve metabolic processes in the brain tissue
• sedatives - have a calming effect by balancing the processes of excitation and inhibition of the nervous system
• antipsychotics - relieve excitement
• antidepressants - remove anxiety, normalize mood

Non-drug methods include:

1. Individual psychotherapy - a psychiatrist-psychotherapist teaches a person to control behavior, to relax. Helps to build priorities (achieve success at work, live in love and harmony with loved ones) and stick to them.
2. Biofeedback therapy — modern method treatment mental disorders... A specialist with the help of sensors and a computer measures physiological indicators - respiratory rate, heart rate, blood pressure level. As soon as a person managed to bring these indicators back to normal (following the instructions of a specialist), the computer reports success. The patient memorizes relaxation skills and can then use them in emotionally stressful situations to pull themselves together.

Diagnosis F06.6 Organic emotionally labile asthenic disorder is often left untreated - others and the person himself believe that he has a "difficult character". But this is wrong. The symptoms of the disorder can be treated with modern drugs and non-drug methods and return to a fulfilling life.

Supportive care includes analgesia, hydration, and bed rest. Penicillin V (Penicillin V) is considered the drug of choice in the treatment of tonsillopharyngitis caused by hemolytic streptococcus group A; the dose is 250 mg orally 2 times a day for 10 days for patients with body weight< 27 кг и 500 мг при массе тела > 27 kg. If a liquid form is required, Amoxicillin is effective and more palatable. If compliance is a problem, a single intramuscular injection of benzathine penicillin at a dose of 1.2 million units (600,000 units for children weighing 27 kg) is effective. Other oral medications include macrolides for patients allergic to penicillin, 1st generation cephalosporins, and clindamycin.
Treatment is started immediately or postponed until culture results are obtained. If treatment is hypothesized, it should be discontinued if culture is negative. Repeated cultures from the pharynx are usually not performed. They are used in patients with frequent relapses of tonsillopharyngitis caused by group A hemolytic streptococcus, or in cases of pharyngitis from close home or school contacts.
Tonsillectomy is considered for frequent relapses of tonsillitis caused by group A hemolytic streptococcus (\u003e 6 episodes per year,\u003e 4 episodes per year for 2 years,\u003e 3 episodes per year for 3 years), or for severe and persistent acute infection. despite antibiotic therapy. Other indications for tonsillectomy include obstructive sleep apnea, recurrent peritonsillar abscess, and suspected cancer.
Various effective surgical techniques are used to perform tonsillectomy, including electrocaustics, microdebrider with simultaneous high-frequency ablation, and sharp dissection. Severe intraoperative or postoperative bleeding occurs in less than 2% of patients, usually within 24 hours after surgery or 7 days after the scab is peeling. Bleeding patients should be taken to hospital. If bleeding continues on arrival, patients are usually examined in the operating room and hemostasis performed. If a thrombus is in the amygdala, patients are monitored for 24 hours. Postoperative intravenous rehydration therapy is required in 3% of patients, and possibly even fewer patients with optimal preoperative infusion therapy, preoperative administration of antibiotics, analgesics and glucocorticoids. Postoperative obstruction respiratory tract most often occurs in children under 2 years of age with previous obstructive sleep apnea and in patients with morbid obesity, neurological diseases, craniofacial pathology and with severe preoperative obstructive sleep apnea. In adults, complications are much more frequent and usually more severe.

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