Cognitive disorders include problems with memory and attention, as well as abnormal sensations or pathologies related to thought processes. Due to the fact that many psychiatric symptoms are classified as cognitive disorders, they are basically the basis of psychopathology.

Cognitive impairmentcan make the life of the experiencing patient much more difficult. Problems may relate to virtually all everyday situations, both professional functioning (difficulties may result, for example, from memory and concentration disorders), and family functioning (here, for example, the patient's beliefs, which he is certain even then, may be problematic, inconsistent with reality, when they are denied by his relatives). Cognitive impairment, due to many factors causing them, can occur in both a child and an elderly person.

Cognitive processesallow people to learn about the environment and communicate with it. They are also an integral element related to the acquisition and consolidation of knowledge. The basic human cognitive processes include:

  • memory,
  • note,
  • perceiving the world through the senses,
  • thinking.

Cognitive functions are disturbedas a result of many different situations, examples of which are:

  • psychiatric problems (e.g. depression, bipolar disorder or delusional syndromes, but also experiencing a traumatic event),
  • neurological diseases (such as stroke, Alzheimer's disease and other dementia syndromes),
  • head injuries,
  • tumors of the central nervous system,
  • severe exacerbations of chronic somatic diseases,
  • use of psychoactive substances (e.g. drugs or alcohol),
  • withdrawal syndromes (related to the discontinuation of drugs that the patient is addicted to - this may apply, for example, to withdrawal from alcohol, but also from medications).

Cognitive impairment: memory

Memory disorders are divided into two groups: quantitative and qualitative memory disorders.

Distinguishes among quantitative memory disorders (dysmnesia)yourself:

  • hypermnesia (exceptionally good memory),
  • hypomnesia (reduced memory capacity),
  • amnesia (out of memory).

The second category of cognitive disorders related to memory are qualitative disorders (paramnesia). This group of problems includes:

  • memory illusions (distorted memories about events that actually happened in the past),
  • cryptomnesia (memories the existence of which the patient is not aware of - the so-called unconscious plagiarism may be committed as a result of cryptomnesia),
  • confabulations (false memories that usually fill some memory gaps of the patient).

Cognitive impairment: note

Disturbance in attention can take the form of impaired concentration, when it is difficult to focus on one activity. There are also excessive shifting of attention (focusing every now and then on a different matter) and its insufficient shifting (changing the source of focus is difficult for the patient).

Another problem is the excessive distraction of attention, where even a seemingly insignificant event (e.g. an insect flying by) completely distracts the patient from the activity on which he was previously focused.

Cognitive dysfunction: perception

Disturbances in perception include illusions, hallucinations and psychosensory disorders.

Illusions (also known as illusions)are incorrect perceptions arising from stimuli reaching the sensory organs. Here it must be emphasized that not all illusions are related to pathology. An example of an illusion may be the impression that there is a stranger outside the window, while there are ordinary tree branches behind it. Pathological delusions are when the patient - despite the logical presentation to him that he is wrong - is still convinced of the truth of his observations.

Thehallucinations (hallucinations)are different from delusions. Their formation is not related to the stimuli reaching the patient. The similarity of hallucinations and illusions, however, concerns the patient's conviction of the truthfulness of the experienced experiences. People who experience hallucinations are not prone to trying to convince themselves that their experiences are not real. Hallucinations can affect any of the senses, which is why hallucinations are distinguished:

  • auditory (hearing different sounds or voices),
  • visual (e.g. seeing a spider on a wall),
  • olfactory (sensation of non-existent smells),
  • taste (feeling the taste despite the lack of a taste stimulus),
  • sensory (e.g. feelingthe presence of worms on the body).

There are the so-called the alleged form of hallucinations (they are also called pseudo-hallucinations). In this case, the abnormal sensations are located inside the patient's body or in some undefined space.

Another problem classified as perception disorders arepsychosensory disorders(parahalucinations). Their genesis is similar to that of hallucinations - these sensations arise without the participation of an external stimulus, but their distinguishing feature is that patients are aware of their unreality. Psychosensory disorders include, among others incorrect perception of the size of objects (when they are perceived as too small, they are referred to as micropsias, while they appear unusually large to the patient - they are referred to as macropsias).

In the course of psychosensory disorders, unreal experiences may also affect other senses: smell, hearing, taste or smell.

Some classifications for perception disorders include two more phenomena:depersonalizationandderealization.Depersonalization is a state in which a person feels detached from himself - in its course the patient has the impression that he is in fact on the side and is only an observer of his corporeality. In the case of derealization, in turn, there is a feeling of changes in the surrounding world - for the patient the world seems strange, strange and unreal.

Cognitive impairment: thinking

Thinking disorders are divided into disturbances in the course, content and logic of thinking. Expression is inherently associated with thought processes, therefore the existence of thinking disorders is suggested mainly by those problems that are noticeable while speaking.

1. In the case ofdisturbances in the course of thinking , the following are distinguished:

  • mutism (complete cessation of speaking, which may be associated with a void of thought),
  • alogy (poverty of thinking),
  • racing thoughts and the related word flow,
  • acceleration of thinking,
  • slowing down your thinking,
  • stopping the thinking (sudden loss of a thread that the patient previously thought about),
  • distraction of thinking (loss of connections between individual threads of thought, which causes the patient to move from one topic to another in a disorganized way when speaking),
  • meticulousness (in the course of thought processes, there are still new, additional thoughts concerning small matters, which makes the patient's statement full of unnecessary details),
  • perseveration (repeating one phrase multiple times),
  • verbigerations (repeating the words thatsound similar to each other),
  • echolalia (unconscious, unreasonable repetition of other people's words),
  • incoherence of thinking (total lack of coherence between thoughts).

2. Another cognitive impairment related to thought processes isthought content disturbance . Among them are delusions (incorrect beliefs), the truth of which patients are so sure that it is impossible to persuade them that they are wrong. The subject of delusions can vary, but the most common are delusions:

  • persecutory (the patient thinks that he / she is being followed and overheard),
  • referring (ksledz) - the patient thinks that he or she is of particular interest to the environment,
  • of jealousy,
  • impact (the patient thinks that third parties control his behavior from the outside, e.g. through a chip implanted under the skin),
  • erotic,
  • sending or receiving thoughts,
  • unveiling (the patient is convinced that his thoughts are communicated to third parties without his participation),
  • somatic (the patient feels symptoms of some serious or fatal disease),
  • great (the sick person claims to be a famous, rich and influential person).

Within the content disorders of thinking there are also overvalued ideas (thoughts) and obsessions. Overvalued thoughts are said when the patient is guided by some bizarre or extremely absurd idea in his life - he usually subordinates his behavior and life to it. Overvalued thoughts may center, for example, around the concept of creating some unusual invention. What distinguishes them from delusions is that the patient is able to assume that their beliefs do not correspond to reality.

Obsessions are intrusive (often unwanted by the patient), constantly recurring thoughts. Most often, compulsions focus on hygienic activities, often accompanied by compulsions (activities for which the patient feels compulsion to perform them).

3. The third group of thinking disorders aredisorders in the logic of thought processes . These include:

  • illogical thinking (while thinking, the patient draws his own cause-effect relationships and notices unusual connections that seem inconsistent with generally accepted logic),
  • magical thinking (related to irrational, extremely difficult to understand mental connections),
  • ambivalence (the appearance of completely contradictory thoughts),
  • dereistic thinking (detached from reality).
About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University ofPoznan. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Read more articles from this author

Category:

Psychiatry