Assessment for Lania

[Patricia Gurria]

,My daughter 21 years old had been diagnoses with a  moderate spastic cuadriparesis cerebral palsy since she was 3 years old.
but no one gave us the awarenes about the cognitive impairment until she was 17.
She developed a depression and a psychiatric tratment started with Risperdal ( Risperidona). She lost a lot of functions so the drug was stoped. She developed a mild neuroleptic syndrome.  She started with akatisia, then she developed a psychosis stage that disappeared 7 months later.
I want to know what is a mydriasis toxic psychosis? and what are the symptoms.
What conection exists between anxiety ( panic) and psychosis?
If dopamin receptors are blocked this can produce anxiety?
The confucion Lania seams to have in her speach comes from the damage in her perception ,this is not  psychosis. Why if an antipsychosis drug is administered, it causes psychosis?
What is a Mental Disorder ?
What is a cognitive disorder?
Cognitive disorder can cause anxiety?

[Patricia Gurria]

Every question I am asking is because nobody of the psychiatrist had answer it in my country. I was to ignorant and they had made a lot of mistakes on her, I am trying to learn in order to be able to help her. The same way I had to learn english, then how to use a computer and now how to find persons who are able to teach me about her problems, and mabe be I will be able to find a good solution for her.
I know every answer has a cost, but the real intention is to have a comunication with some one who is impartial, and an other very important matter is that your neuro-psychiatric knowledges are 50 years ahead of ours.
Lania

[HFHS MD-JM]

Patricia,

        You have several questions regarding your daughters condition-cerbral palsy with related depression and cognitive impairment.  It also appears that she also experienced some side effects from Risperdal-akathisia.
        I can not diagnose or discuss your daughters case without a more comprehensive history but, recommend that you discuss these issues further with your daughters psychiatrist.
        A mental disorder is a clinically significant behavior/psychological syndrome(ie depression, anxiety, etc) associated with distress or disability.  It is not an expected response to a particular event or limited to relations between a person and society.
        A cognitive disorder is characterized by an impairment in memory, concentration or language (ie cognition).  Examples include dementia, delirium, and amnestic disorders. Cognitive disorders can be associated with anxiety and often is in earlier stages of the illness.
        I defer the rest of your questions to your daughters psychiatrist/physician as I believe it is important for you to have further clarification on your daughters condition and diagnosis.  Keep in mind that this information is intended for educational purposes only.

Sincerely,

HFHS MD-JM

Keywords: Menatl disorder, cognitive disorder

[NRO-Sx]

First, mydriasis is a term that means dilated (widened) pupils, and acute toxic psychosis means "drug-induced" psychosis. Second, some antipsychotic drugs can cause dry mouth, impaired vision, and changes in heart rate which could lead to a feeling of "uneasiness" or anxiety.  Psychosis is a term for disordered thought (e.g. delusions), and can be made worse by anxiety.  Third, it is unlikely that blocking dopamine receptors per se will produce anxiety, however, some antipsychotic drugs affect receptors other than dopamine receptors (e.g. acetylcholine receptors and norepinephrine receptors) and the combined effect could possibly produce symptoms of anxiety.  Finally, a cognitive disorder is a disorder with rational thought processes (e.g. understanding logical arguments) and NOT with sensory perception (e.g. color, size, shape, sound etc.).  I'm not certain whether cognitive disorders commonly cause anxiety, but it seems possible that a cognitive disorder could cause benign, everyday aspects of life to be misinterpreted, and hence cause anxiety.
Hope this answers your questions!