Cognitive and dissociative disorders Notes

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Osmosis High-Yield Notes

This Osmosis High-Yield Note provides an overview of Cognitive and dissociative disorders essentials. All Osmosis Notes are clearly laid-out and contain striking images, tables, and diagrams to help visual learners understand complex topics quickly and efficiently. Find more information about Cognitive and dissociative disorders by visiting the associated Learn Page.
NOTES NOTES COGNITIVE & DISSOCIATIVE DISORDERS GENERALLY, WHAT ARE THEY? PATHOLOGY & CAUSES ▪ Cognitive disorders: involve cognitive decline ▪ Dissociative disorders: involve detachment from past/present versions of oneself/the world SIGNS & SYMPTOMS ▪ See individual disorders DIAGNOSIS ▪ See individual disorders CAUSES ▪ Past trauma/stress may cause/worsen condition TREATMENT ▪ See individual disorders COMPLICATIONS ▪ Personality changes, depression AMNESIA osms.it/amnesia PATHOLOGY & CAUSES ▪ Acute loss of memory TYPES Anterograde amnesia ▪ Inability to form new memories ▪ Associated with encoding and consolidation phases of memory ▪ Usually involves damage to prefrontal cortex/hippocampus Retrograde amnesia ▪ Inability to recall old memories (may result in creation of false memories) 696 OSMOSIS.ORG ▪ Associated with storage and retrieval phases of memory ▪ Usually involves damage to cortex CAUSES ▪ Head trauma, infection, neurodegenerative diseases (e.g. dementia/Alzheimer’s), brain tumours, thiamine deficiency (causing Wernicke–Korsakoff syndrome), benzodiazepines, electroconvulsive therapy COMPLICATIONS ▪ Range of potential complications (e.g. confusion, loss of identity)
Chapter 91 Cognitive & Dissociative Disorders TREATMENT SIGNS & SYMPTOMS ▪ Acute memory loss, affects memories created before/after an event (or onset of illness) PSYCHOTHERAPY ▪ Occupational and cognitive therapies to enhance memory OTHER INTERVENTIONS DIAGNOSIS ▪ Often temporary (address cause) ▪ Mobile phones and digital devices as workarounds to memory loss DIAGNOSTIC IMAGING MRI/CT scan ▪ Brain damage/abnormalities LAB RESULTS ▪ Nutritional deficiencies/infections DELIRIUM osms.it/delirium PATHOLOGY & CAUSES ▪ Fast decline in attention/consciousness, thinking ▪ Sometimes accompanied by symptoms of hyper/hypoactivity RISK FACTORS ▪ Disease (e.g. dementia, constipation, pneumonia, UTIs) ▪ Post-surgical complications ▫ Medications (e.g. narcotic pain medications, benzodiazepines, hypnotics, anticholinergics) ▫ Altered metabolic homeostasis (e.g. electrolyte or imbalance), chronic fatigue ▪ Increases risk of falling over → broken bones, head injuries, bruises, bleeds → longer hospitalizations, more complications, higher mortality rates SIGNS & SYMPTOMS ▪ Difficulties with attention span, concentration, remaining conscious ▪ Disorganized/delayed thinking ▪ Hyperactive symptoms ▫ Agitated/aggressive ▫ Delusions/hallucinations ▪ Hypoactive symptoms ▫ Sluggish, drowsy ▫ Less reactive, withdrawn DIAGNOSIS ▪ Issues with attention/consciousness and cognition, developing over short time (several days or fewer) ▫ Difficulties with attention span, concentration, remaining conscious ▫ Disorganized/delayed thinking ▪ Not explained by pre-existing neurocognitive condition ▪ Explained by other medical condition and/or exposure to/withdrawal from a substance OSMOSIS.ORG 697
TREATMENT MEDICATIONS Severe symptoms ▪ Haloperidol/second generation antipsychotics OTHER INTERVENTIONS Preventative ▪ Make high-risk targets feel oriented, comfortable (reducing excess noise/ stimulation; make sure glasses, hearing aids are used if needed; encourage daily routine) ▪ Avoid opiates, other causative medications; avoid restraints DISSOCIATIVE DISORDERS osms.it/dissociative-disorders PATHOLOGY & CAUSES ▪ Characterized by disruptions or breakdowns of memory, awareness, identity, or perception. TYPES ▪ Three types on scale of severity Low severity: depersonalization/derealization disorder ▪ Depersonalization: feeling detached from own body/mind (e.g. feeling one’s body is a robot/ feeling of watching self) ▪ Derealization: feeling of world not being fully real (e.g. feeling outside world not real/ lacks lucidity) Middle severity: dissociative amnesia ▪ Inability to recall significant information about oneself (e.g. location of childhood home, what mother looked like) ▪ Four categories of amnesia ▫ Localized: trouble recalling traumatic event (and surrounding period) ▫ Generalized: trouble recalling significant portion of one’s past ▫ Systematized: trouble recalling specific category of information ▫ Continuous: trouble recalling events after they occur ▪ Can involve dissociative fugue (individual becomes confused about identity, starts sudden travel/ wandering) 698 OSMOSIS.ORG ▪ Worsens under stress High severity: dissociative identity disorder ▪ Feeling of having multiple identities which act/think/perceive differently, thus impairing ability to recall everyday/important information about oneself ▪ Two categories of dissociative identity disorder ▫ Covert: individual aware of identity shifts, struggles to manage them ▫ Overt: individual completely assumes different identities while unaware ▪ Can involve dissociative fugue (individual becomes confused about identity, starts sudden travel/ wandering) CAUSES ▪ Thought to be primarily caused by psychological trauma; associated with sexual abuse, post-traumatic stress disorder, depression, substance abuse, borderline personality, somatoform conditions ▪ More common in biologically-female indiviudals SIGNS & SYMPTOMS Depersonalization/derealization disorder ▪ Explicit thoughts/behaviors related to depersonalization/derealization ▪ Emotional/physical numbness; weak sense of self
Chapter 91 Cognitive & Dissociative Disorders ▪ ▪ ▪ ▪ ▪ Deadpan speech Altered sense of time Brain fog/lightheadedness Prone to rumination, anxiety Severe symptoms: difficulty recognizing familiar places, people, objects Dissociative amnesia & Dissociative identity disorder ▪ Inability to recall significant information about oneself ▪ Altered consciousness (e.g. depersonalization, derealization) ▪ Depression, suicidal ideation DIAGNOSIS TREATMENT MEDICATIONS ▪ Antidepressants (like selective serotonin reuptake inhibitors) ▪ Mood stabilizers ▪ Neuroleptics PSYCHOTHERAPY ▪ E.g., psychodynamic, cognitive, cognitive behavioral, supportive OTHER INTERVENTIONS ▪ Memory aids: alarms, reminders, media (e.g. photos/videos/recordings) ▪ Occupational therapy Depersonalization/derealization disorder ▪ Presence of depersonalization/derealization ▪ Symptoms affect day-to-day functioning ▪ Not caused by other condition/substance Dissociative amnesia ▪ Inability to recall significant information about oneself, beyond everyday forgetting ▪ Symptoms affect day-to-day functioning ▪ Not caused by other condition/substance Dissociative identity disorder ▪ Feeling of having multiple identities which act/think/ perceive differently ▪ Inability to recall significant information about oneself, beyond everyday forgetting ▪ Symptoms affect day-to-day functioning ▪ Not described by cultural/religious practices, nor by play (e.g. imaginary friends) ▪ Not caused by other condition/substance OSMOSIS.ORG 699

Osmosis High-Yield Notes

This Osmosis High-Yield Note provides an overview of Cognitive and dissociative disorders essentials. All Osmosis Notes are clearly laid-out and contain striking images, tables, and diagrams to help visual learners understand complex topics quickly and efficiently. Find more information about Cognitive and dissociative disorders by visiting the associated Learn Page.