Clinical Approach to Personality Change Due to Another Medical Condition.

Area of Science:

• Neurology
• Psychiatry
• Neuropsychology

Background:

• Medical personality change (MPC) is a codable diagnosis (F07.0) often overlooked and misdiagnosed as depression or anxiety.
• MPC presents with impaired judgment and life dysfunction, impacting functioning, occupation, and relationships.
• This condition warrants greater clinical consideration due to its significant impact.

Purpose of the Study:

• To provide a clinically focused review of Medical Personality Change (MPC).
• To review MPC clinical assessment and categorize its subtypes based on frontotemporal-subcortical circuits.
• To discuss management strategies for MPC subtypes.

Main Methods:

• Categorization of MPC subtypes: apathetic (ventromedial prefrontal cortex), labile/disinhibited (orbitofrontal cortex), and aggressive/paranoid (medial temporal lobes).
• Review of clinical presentation and management for each category.
• Focus on common etiologies: traumatic brain injury, Huntington disease, and brain tumors.

Main Results:

• Description of clinical presentations for apathetic, labile, disinhibited, aggressive, and paranoid MPC subtypes.
• Review of management strategies tailored to each subtype.
• Discussion of how MPC features from TBI, Huntington disease, and brain tumors generalize to other etiologies.

Conclusions:

• MPC requires clinical attention due to the dysfunction and distress it causes.
• Further research is needed to characterize MPC phenotypes.
• Development of tailored assessment instruments and effective treatments for MPC is essential.