Primary Psychiatric Behavioral Disorders Indicative of Neuropathological Processes: A Review of 125 Cases

Abstract

Some manifestations attributed to a primarily psychiatric disorder may result from an identified or unidentified neurological lesion; in other words, psychiatric symptoms are often a common determinant for both neurological pathologies and psychopathological disorders. The objective of this work was to study the radio-clinical profile of psychiatric manifestations attributable to a neurological process. We therefore carried out a retrospective cross-sectional study with a descriptive aim. The survey took place from December 2018 to March 2019 at the Abidjan Addictology and Mental Hygiene Service (SAHM) of the National Institute of Public Health (INSP). The period studied was 08 years (2012-2019). Thus, 47169 patient files were identified over this period (2012 to 2019). A total of 125 patient files meeting the inclusion criteria were selected from an exhaustive sampling. It should be noted that the use of specific biomarkers was not possible in our context. There was a modest female predominance of 52.80%, a mean age of 65 years. Clinical characteristics revealed a history of hypertension (23.2%). Call signs were amnesia (80.5%), incoherent speech (45.5%) and the delirium-hallucination dyad (40.9%). A dementia syndrome was evoked in a proportion of (61.6%); it required neuroimaging. In 96.8% of the cases, the brain scan revealed cortico-subcortical atrophy lesions (66.4%), but MRI could only be performed in (3.2%). Degenerative, vascular or mixed etiologies were evoked in 34.4%, 15.2% and 30.4% respectively. The risk of excessive psychiatry and misdiagnosis of behavioral disorders reveals the interest of a more elaborate neuropsychiatric evaluation and the use of neuroimaging.