A. Medeiros, Portugal
Hospital Garcia de Orta, E.P.E. Psychiatry and Mental Health DepartmentPresenter of 2 Presentations
EPP1360 - The concept of motivation and its implication in additive disorders
ABSTRACT
Introduction
The word motivation derives from the Latin movere, which means to move. In psychiatry, it is an isolated phenomenon found in the substrate of several pathologies, and may be part of an heterogeneous dimensional spectrum. However, there is no unique definition for it, nor a targeted approach. In addictive disorders motivation gains a fundamental role, both as a precipitant of abuse as in its withdrawal.
Objectives
To review the literature about the concept of motivation and its implications on the psychopathology, especially on addictive disorders.
Methods
Narrative review on PubMed/MEDLINE, using the keywords “motivation” AND “psychopatology” AND “addiction”. Articles in English and Portuguese were included.
Results
Three main perspectives were found addressing the concept of motivation in psychopathological terms: psychological, neurobiological and phenomenological. The first describes motivation as the energizing of behaviour in pursuit of a goal. Neurobiology says motivational drive is dependent on the concentration of extrasynaptic dopamine. In phenomenological terms, the concept stands for the web of solicitations that make a certain situation feel in a certain way for the subject. In addictive disorders, learning about what leads to reward, exaggeration in representing those values, and dominance in being guided by those representations lead to alterations on motivation mechanisms.
Conclusions
Motivation is described from different perspectives. Although it is recognized as a fundamental piece in addictive disorders, besides motivational interview model, there are no pharmacological approaches aimed to improving motivation. The recognition of motivation as a concrete psychopathological alteration, and its measure through psychopathological instruments, could optimize the patient’s approach.
O267 - Hebephrenic Schizophrenia As A Variant Of Frontotemporal Dementia – The True Dementia Praecox?
ABSTRACT
Introduction
Frontotemporal Demential (FTD) is a neurodegenerative disorder evolving the frontal or temporal brain lobes. They have been described six variants. Behaviour variant (BvFTD) is the most common, and is characterized by changes in social behaviour and conduct, with loss of social awareness and poor impulse control. Hebephrenic schizophrenia (HSz), or disorganized schizophrenia, was recognized as a schizophrenia subtype, characterized by desorganized behaviour and a cognitive deteriorization. Subtypes of schizophrenia are no longer recognized as separate conditions neither in the Diagnostic and Statistical Manual of Mental Disorders, nor in the new International Statistical Classification of Diseases.
Objectives
To review the literature about the concepts of hebephrenic schizophrenia and their similarities with the concept of frontotemporal dementia
Methods
Narrative review of the literature on PubMed/MEDLINE, using the keywords “hebephrenic szchizophrenia” AND “frontotemporal dementia”. Only articles in English were included.
Results
Some authors described dificulty in establish a diferential diagnosis between HSz and BvFTD. HSz has an earlier onset. However, BvFTD is an early age dementia. The fenomenology of both diseases is similar, and schizophrenia was historical conceptualized as praecox dementia. Frontotemporal abnormalities are common neuroimagiological findings in schizophrenia. Clinically, FTD shows a profound alteration in personality and social conduct, emotional blunting and loss of insight. Memory, intellectual functions, executive and attentional abilities may be disturbed in both.
Conclusions
A diferential diagnosis between HSz and BvFTD is dificult to establish (clinically and imagiologically). The response to treatment is weak in both. It should be investigated the possibility they could be the same syndrome, onseting in diferent ages.