EPA-1665 – Organic personality disorder – conceptual principles, psychopathology and therapy

Abstract

Objective The organic personality disorder (OPD) is a multi-faceted group of dia-gnoses in the boarder area of psychiatry and neurology. In the current teaching books OPD is treated rather cursorily. Evidence-based guidelines have not been published. However, OPD is a frequently observed phenomenon both in psychiatry and neurology. Method In the present study an overview is given over historic conceptual principles of OPD. Furthermore, we searched MEDLINE for relevant studies regarding psycho-pathology of OPD. Twelve studies were included in the final analysis. Findings regarding etiology, symptomatology and treatment are summarized. Results Psychopathology was not specific to type of etiology. Three major groups of symptomatology were identified (enechy-type, apathy and depression-type, impulsiveness and affective lability-type). There are no evidence-based treatement recommendations for OPD, a small number of case reports suggest a possible therapeutic effect of carbamazepine and trazodone. Conclusion With regard to psychopathology the traditional classification of Kurt Schneider was affirmed. A multiaxial diagnostic process can integrate a symptomatological and etiological perspective on OPD. Pharmacotherapy should focus on specific syndromes, e.g. hostility. There is a need for further research with the objective of preparing a clinical guideline.