Van: [log in to unmask]
Datum: 29-7-97 12:13
Onderwerp: dementia and psychosis
Dear listreaders
Three listmembers had questions about psychosis and dementia: Naomi,
Sharon and Mary. It seems to me important to understand this are two
different things. You said that,Jerry implicit in your answer.
In psychotic patients intelligence and memory as such are intact,
but the person is confused. He can't differentiate which things
come from the outside world and which from fantasy. A person who
hallucinates while not in a state of drowsiness or near sleep is
psychotic, only very mildly if he knows what is hallucination and
what is real, but seriously if that is impossible. A psychotic
person may hear voices to which he has to obey, he may know for
sure that the voice from the radio is talking to him personally.
He can be very afraid because he is sure there is a complot to kill
him or he can feel others can come in his brain and steal his
thoughts. Or he may talk only gibberish.
The PDmeds may cause psychotic symptoms, mostly mild ones, which
dissapear when the meds are dicontinued or an anti-psych. med is
used. The most psychotic symptoms are seen in schizophrenics.
The cause of schizophrenia is unknown but what is known is
that Schizs have too much dopamine in their brain. The paranoia
and hallucinations of Naomi's husband are psychotic symptoms,
most probable meds induced.
Dementia is a state in which the intellectual and memory functions are
destroyed. That too can cause confusion and anxiety, but these are of
another kind than the psychotic ones,less bizarr and more depending on
loss of orientation in place and time. Of course it is possible a patient
suffers from both: psychosis and dementia.
Dementia is the most important symptom of Alzheimer's disease. In
patients with Alzheimer a destruction of the brain tissue can be seen
on scans. Memory is destroyed with the principle latest in first out.
So it seems the patient is going back in his life. A typical Alzheimer
patient may be upset because his mother doesn't know where he is and he
must go home.
Has dementia a place in PD and what is PD dementia.
PWP's seem to run a bit higher risk to be a PWAlzheimer too then
others.A part of PWP's have an extra symptom, which causes
destruction of brain tissue and hence dementia. The destruction
of the brain is not of the same kind as in Alzheimer ( so called
Lewy bodies are formed) but I don't know wether this is relevant
for the patient. This is called PD dementia. It has to be clear
that it is not for every PWP the unavoidable future.
In many textbooks about neurological diseases is stressed that
dementia belongs to PD and every PWP, who does not die before,
will develop PD dementia. This is confusing, because every
veteran knows that is not true. The person who is the seniority
champ of this list has lived now 50 year with PD and is not
dement.
Research on the intellectual functions of PWP's has revealed
that two functions usually deteriorate. Rote learning takes
more time in PWP's than in others of the same age. PWP's have
more problems with orientation in space than others.
Ida Kamphuis, Holland
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