Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Behaviour and personality change in adults is an important red flag in clinical practice. It may present as aggression, apathy, disinhibition, poor judgement, emotional lability, or loss of empathy. ๐ Key principle: always consider organic/neurological causes first before attributing to primary psychiatric illness.
Category | Examples | Clinical Clues |
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Neurological |
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Disinhibition, apathy, impaired executive function, seizures, focal neurological signs |
Metabolic/Medical |
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Acute delirium, fluctuating confusion, systemic illness clues |
Infective |
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Fever, meningism, headache, seizures, acute onset |
Psychoactive Substances |
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Temporal link with substance use or new medication |
Primary Psychiatric |
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Subacute or chronic course, younger age, no organic features |
โ Depends entirely on the underlying cause. Some (e.g. infection, metabolic disturbance) are reversible with treatment. โ ๏ธ Others (e.g. dementia, brain tumours) carry a poorer prognosis and require long-term support. ๐ The key clinical pearl: sudden or progressive personality change in adults must never be dismissed as "just psychiatric" without ruling out organic causes.
Behavioural and personality change in adults is a red-flag presentation. A structured approach โ history, collateral, neurological exam, and targeted investigations โ is essential to differentiate organic, psychiatric, and substance-related causes. Early recognition and management can be life-saving.